Mark H Eikenberry, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

42311 Issued in MN

Practice address

2530 Chicago Ave S
Suite 400
Minneapolis, MN 55404-4387

Phone

(612) 813-3300

Fax

(612) 813-3349

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Respiratory & Critical Care Specialists. P.a.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
  • NPI 1003816505
  Medicare reassignment NPD
• Gillette Children's Specialty Healthcare

  dba Gillette Children's Professional Services

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1225119175
  Medicare reassignment NPD
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment NPD
• Gillette Children's Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1982090528
  NPD
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD (past)
• Gillette Children's Specialty Healthcare

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1447352836
  NPD (past)
• Gillette Children's Specialty Healthcare

  dba Gillette Children's Healthcare MNTK

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1265405120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIKENBERRY",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "31493",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MN",
            "license": "42311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798621",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay Henry Eidem, PHARMD
• Keith E Eidman, DO
• Siri TS Eidsmo
• Erin Eidsness, MD
• Andrea Eiesland, OTR
• Eiko Mizushima Integrative OT LLC
• Brady D Eilertson, APRN, CRNA
• Tiffany Eininger
• Angela M Eischens, LMFT
• Todd Louis Eisenberg, M.D.

• Pediatric Critical Care Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Critical Care Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.