Gregory Gerald Mevissen, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

33592 Issued in MN

Practice address

3366 Oakdale Ave N
Suite 315
Robbinsdale, MN 55422-2948

Phone

(763) 520-7900

Fax

(763) 520-7989

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

University of Minnesota Medical School, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1578932943
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• North Clinic, PA

  • Multi-Specialty Clinic/Center
  • Brooklyn Park, MN
  • NPI 1407011760
  NPD (past)

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

• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1174980692
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1245615772
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • Mental Illness Community Based Residential Treatment Facility
  • St Louis Park, MN
  • NPI 1578717336

  Hospital

  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1942585286
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295763837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 315",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-520-7900",
            "fax_number": "763-520-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 315",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-520-7900",
            "fax_number": "763-520-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEVISSEN",
        "first_name": "GREGORY",
        "middle_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "33592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121892100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rohaan F. Mehta, M.D.
• Samantha J Melchior
• Stephen Evans Omondi Menya, D.C
• Kristin Meschke
• Steven T Mestitz, MD
• Elizabeth Meyer, DPT
• Michael J Anderla D.C., P.a.
• Jeffrey Middendorf
• Christopher Michael Cooper Miller, MD
• Matthew Daniel Miller, D.C.

• Gastroenterology Physician in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Gastroenterology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.