Richard Peter Cervenka, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

304 Issued in MN

Practice address

3790 117TH LN NW
Coon Rapids, MN 55433-2666

Phone

(763) 421-7300

Fax

(763) 421-3337

NPI assigned

Sep 23, 2005

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Christopher Weis

  • Foot & Ankle Surgery Podiatrist
  • Richfield, MN
  • NPI 1780871848
  NPD (past)
• West Imaging, LLC

  • Diagnostic Radiology Physician
  • Robbinsdale, MN
  • NPI 1053311399
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1306832464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3790 117TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332666",
            "telephone_number": "763-421-7300",
            "fax_number": "763-421-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 117TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332666",
            "telephone_number": "763-421-7300",
            "fax_number": "763-421-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVENKA",
        "first_name": "RICHARD",
        "middle_name": "PETER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MN",
            "license": "304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042325400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "34039CE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noah Benjamin Case
• Alyssa Kathryn Cassiere
• Rachael Caughey
• Centered Health Chiropractic P a
• Jayne Cernohous, DDS
• Tang Cha, LICENSED RN
• Randall Chadwick Jr., MD
• Jhordyn Chalmers
• Cheryl Champion, LICSW
• Khalilah Chandler

• Foot Surgery Podiatrist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Foot Surgery Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.