Individual provider Active NPI

Benjamin W Eidem, M.D.

  • Pediatric Cardiology Physician
  • Rochester, MN
National Provider Identifier
1306869433
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
37342 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 38232 WI
Pediatric Cardiology Physician 2080P0202X 37342 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address beidem113070@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20060118000983 MN Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 5496641052 Reassigns benefits to 10 organizations
I20070410000597 ND Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric MedicinePractitioner - Other (Physician) 5496641052 Reassigns benefits to 2 organizations
I20140912000923 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 5496641052 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39694TXMDDentist
37342MNMDPediatric Cardiology Physician
38232WIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Sep 15, 2015 Accepting new patients
Winneshiek Medical Center CurrentSince Oct 20, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 22, 2013 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 5, 2014 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 1, 2017 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jul 1, 2017 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-St James CurrentSince May 15, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 22, 2013 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Altru Health System CurrentSince Sep 15, 2015 Accepting new patients
St Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 1, 2017 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Apr 20, 2013 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 5, 2014 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Mayo Clinic CurrentSince Mar 28, 2015 Accepting new patients
Winneshiek Medical Center CurrentSince Oct 20, 2018 Accepting new patients
Mayo Clinic Past Accepting new patients
Elmhurst Memorial Healthcare PastSince May 25, 2021 Accepting new patients

Locations

901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

114 Main St S
Mabel, MN 55954
Phone (507) 493-5115

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

2000 North Ave
Northfield, MN 55057
Phone (507) 646-1000

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925

310 N 10th St
Bismarck, ND 58501
Phone (701) 530-7500

222 N 7th St
#One
Bismarck, ND 58501

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

530 W Cairns St
Ellsworth, WI 54011
Phone (715) 273-5061

403 N Maple St
Ellsworth, WI 54011
Phone (715) 273-5821

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1306869433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEM",
        "first_name": "BENJAMIN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "38232",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "37342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beidem113070@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.