Individual provider Active NPI

Mark Stuckey, MD

  • Anesthesiology Physician
  • Minneapolis, MN
National Provider Identifier
1265475263
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
33411 Issued in MN
Practice address
516 Delaware Street SE
Ump PM&R Clinic
Minneapolis, MN 55455
Phone
(612) 884-0649
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 33411 MN Primary

Addresses

Primary practice location

516 Delaware Street SE
Ump PM&R Clinic
Minneapolis, MN 55455

Mailing address

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone (612) 884-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MS, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040421000320 MN Practitioner - Anesthesiology 4284547779 Reassigns benefits to 3 organizations
I20230502002748 MS Practitioner - Anesthesiology 4284547779 Reassigns benefits to 1 organization
I20240131001039 GA Practitioner - Anesthesiology 4284547779

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Minnesota Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 273-3000

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33411MNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Providers, LLC Anesthesiology CurrentSince Jun 1, 2005 Accepting new patients
Perioperative Services of Mississippi, LLC Anesthesiology CurrentSince Feb 13, 2023 Accepting new patients
Twin Cities Anesthesia Associates PC Anesthesiology CurrentSince Sep 1, 2017 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 26, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc Anesthesiology CurrentSince Jun 26, 2023 Accepting new patients

Locations

14500 99th Ave N
Ste 500
Maple Grove, MN 55369
Phone (763) 898-1400

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

Interoperability endpoints

  • Direct secure messaging: mstuckey148121@fairview.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1265475263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE STREET SE",
            "address_2": "UMP PM&R CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-884-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "33411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.