Individual provider Active NPI

Marcia A Caron, MD

  • Obstetrics & Gynecology Physician
  • St Louis Park, MN
National Provider Identifier
1285611137
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
45329 Issued in MN
Practice address
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3123
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 45329 MN Primary

Addresses

Primary practice location

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728

Other identifiers 1

IdentifierTypeStateIssuer
480659000MedicaidMN

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
I20100521000037 MN Practitioner - Obstetrics/Gynecology 5698794485 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45329MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Obstetrics & Gynecology CurrentSince Apr 7, 2003 Accepting new patients
Park Nicollet Clinic Obstetrics & Gynecology Current Accepting new patients
Park Nicollet Methodist Hospital Past Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

6500 Excelsior Blvd
Ste 3W
St Louis Park, MN 55426
Phone (952) 993-5000

Interoperability endpoints

  • Direct secure messaging: mcaron157221@direct.healthpartners.com

Organizations & group practices 3

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1285611137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARON",
        "first_name": "MARCIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "45329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480659000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.