Individual provider Active NPI

Joel Syvrud, DPM

  • Podiatrist
  • Saint Cloud, MN
National Provider Identifier
1356355630
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
618 Issued in MN
Practice address
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone
(320) 252-1670
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 618 MN Primary

Addresses

Primary practice location

4801 Veterans Dr
Saint Cloud, MN 56303-2015

Mailing address

4801 Veterans Dr
Saint Cloud, MN 56303-2015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310002313 MN Order and Referring Only - PodiatryPractitioner - Podiatry 5991981870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356355630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015",
            "telephone_number": "320-252-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYVRUD",
        "first_name": "JOEL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.