Individual provider Active NPI

Allan R Hartsough, MD

  • Obstetrics & Gynecology Physician
  • Burnsville, MN
National Provider Identifier
1265498331
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
39641 Issued in MN
Practice address
303 Nicollet Boulevard
Burnsville, MN 55337
Phone
(952) 892-8770
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20046 AZ
Obstetrics & Gynecology Physician 207V00000X 39641 MN Primary

Addresses

Primary practice location

303 Nicollet Boulevard
Burnsville, MN 55337

Mailing address

303 E Nicollet Blvd
Burnsville, MN 55337-4522

Other practice location 1

269 S Candy Ln
Cottonwood, AZ 86326-4158
Phone (928) 639-6025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, AZ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20050620000216 MN Practitioner - Obstetrics/Gynecology 0840234985 Reassigns benefits to 2 organizations
I20200520001335 AZ Practitioner - Obstetrics/Gynecology 0840234985 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20046AZMDObstetrics & Gynecology Physician
39641MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Fairview Clinics CurrentSince Mar 31, 1997 Accepting new patients
Fairview Health Services Current Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Apr 18, 2020 Accepting new patients
Fairview Health Services CurrentSince Apr 18, 2014 Accepting new patients
Fairview Clinics CurrentSince Mar 31, 1997 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Apr 18, 2020 Accepting new patients
Verde Valley Medical Center Past Accepting new patients

Locations

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

303 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 460-4000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

6545 France Ave S
Ste 586
Edina, MN 55435
Phone (952) 915-8770

18580 Joplin Ave
Lakeville, MN 55044
Phone (952) 892-9500

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1265498331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 NICOLLET BOULEVARD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-892-8770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 S Candy Ln",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863264158",
            "country_code": "US",
            "telephone_number": "928-639-6025",
            "fax_number": "928-634-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTSOUGH",
        "first_name": "ALLAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "20046",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "39641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.