Individual provider Active NPI

Susan Margaret Lou

  • Gastroenterology Physician
  • Saint Paul, MN
National Provider Identifier
1316387277
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
63005 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3242
Fax
(651) 254-1553
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63005 MN
Gastroenterology Physician 207RG0100X 63005 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

420 Delaware St SE
MMC 284, UMN Internal Medicine
Minneapolis, MN 55455-0341
Phone (612) 626-5031

Other practice location 2

6401 France Ave S
Edina, MN 55435
Phone (952) 924-5000

Other practice location 3

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606001970 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 5991003998 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63005MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Fairview Health Services CurrentSince Apr 14, 2018 Accepting new patients
Group Health Plan, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Apr 14, 2018 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

420 Delaware St SE
Ste MMC284
Minneapolis, MN 55455
Phone (612) 625-5454

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 7

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1316387277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3242",
            "fax_number": "651-254-1553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_2": "MMC 284, UMN Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-626-5031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "55435",
            "country_code": "US",
            "telephone_number": "952-924-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOU",
        "first_name": "SUSAN",
        "middle_name": "MARGARET",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "63005",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "63005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.