Active NPI
Noel Anthony Hauge, M.D.
- Dermatology Physician
- Eagan, MN
National Provider Identifier
1306955802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 24301
- Practice address
- 1215 Town Centre Dr
Suite 200
Eagan, MN 55123-1033 - Phone
- (651) 251-3300
- Fax
- (651) 255-3450
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 24301 | MN | Primary |
Addresses
Primary practice location
1215 Town Centre Dr
Suite 200
Eagan, MN 55123-1033
Mailing address
60 Plato Blvd E
Suite 270
Saint Paul, MN 55107-1827
Phone (651) 209-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045893700 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24301 | MN | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1306955802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 PLATO BLVD E",
"address_2": "SUITE 270",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551071827",
"telephone_number": "651-209-1600",
"fax_number": "651-291-9169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 TOWN CENTRE DR",
"address_2": "SUITE 200",
"city": "EAGAN",
"state": "MN",
"postal_code": "551231033",
"telephone_number": "651-251-3300",
"fax_number": "651-255-3450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUGE",
"first_name": "NOEL",
"middle_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "24301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "045893700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.