NPIMap

Organization Active NPI

Neuroglee Care PLLC

  • Neurology Physician
  • Rochester, MN
National Provider Identifier
1336858232
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROGLEE CARE PLLC
Practice address
221 1St Ave SW Ste 610
Rochester, MN 55902-4504
Phone
(857) 557-5777
Fax
(857) 557-5778
NPI assigned
Nov 18, 2022
Organization subpart
Yes
Parent organization
NEUROGLEE CARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Ravi Patel, DO
Title
Medical Director
Phone
(352) 313-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

221 1St Ave SW Ste 610
Rochester, MN 55902-4504

Mailing address

101 Arch St FL 8
Boston, MA 02110-7500
Phone (857) 557-5777

Other names 2

  • Neuroglee Health Doing business as
  • Neurolglee Therapeutics INC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230106001585 MN Part B Supplier - Clinic/Group Practice 5698141240 Receives reassigned benefits from 2 practitioners
Practice locations: Rochester, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Neuroglee Care PLLC9 organizations share this tax ID, including this one
Part of
Neuroglee Care PLLC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

221 1st Ave SW
Ste 610
Rochester, MN 55902
Phone (857) 557-5777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1336858232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ARCH ST FL 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021107500",
            "telephone_number": "857-557-5777",
            "fax_number": "857-557-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 1ST AVE SW STE 610",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024504",
            "telephone_number": "857-557-5777",
            "fax_number": "857-557-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROGLEE CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEUROGLEE CARE PLLC",
        "enumeration_date": "2022-11-18",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-313-8000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuroglee Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neurolglee Therapeutics INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.