Individual provider Active NPI

Logan Andrew Newman, MD

  • Pediatrics Physician
  • St Cloud, MN
National Provider Identifier
1285070243
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60534 Issued in MN
Practice address
1200 Sixth Ave N
St Cloud, MN 56303-2735
Phone
(320) 251-2700
Fax
(320) 656-7115
NPI assigned
May 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60534 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1200 Sixth Ave N
St Cloud, MN 56303-2735

Mailing address

1200 Sixth Ave N
St Cloud, MN 56303-2735
Phone (320) 251-2700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160621002100 MN Practitioner - Pediatric Medicine 3375849698 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Aug 15, 2016 Accepting new patients
Centracare Clinic CurrentSince Aug 15, 2016 Accepting new patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

Interoperability endpoints

  • Direct secure messaging: lnewman303700@direct.centracare.com

Organizations & group practices 4

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": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1285070243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "LOGAN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-17",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "60534",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.