Active NPI
Fairview Bethesda Hospital
- Internal Medicine Physician
- Minneapolis, MN
National Provider Identifier
1275412561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- FAIRVIEW BETHESDA HOSPITAL
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Phone
- (855) 324-7843
- NPI assigned
- Aug 29, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Charles Gaylord
- Title
- Chief Financial Officer
- Phone
- (612) 672-6119
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031208000483 | MN | Part B Supplier - Clinic/Group Practice | 7214833763 |
Receives reassigned benefits from 526 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saint Paul, MN |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Fairview Bethesda Hospital
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Institutional Pharmacy
- Saint Paul, MN
- NPI 1346097284
-
- Health Service Clinic/Center
- Saint Paul, MN
- NPI 1447990072
-
- Home Infusion Therapy Pharmacy
- Saint Paul, MN
- NPI 1942663711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756425600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756425600000",
"number": "1275412561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "855-324-7843"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRVIEW BETHESDA HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-29",
"last_updated": "2025-08-29",
"certification_date": "2025-08-29",
"status": "A",
"authorized_official_last_name": "GAYLORD",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "612-672-6119"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.