Active NPI
Dennis Dale Dykstra, M.D.
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
National Provider Identifier
1376571950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 26055
- Practice address
- 516 Delaware Street SE
PWB 1St FL Clinic 1a University of Minnesota Physicians
Minneapolis, MN 55455 - Phone
- (612) 626-6688
- NPI assigned
- Jun 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 26055 | MN | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 26055 | MN | Primary |
Addresses
Primary practice location
516 Delaware Street SE
PWB 1St FL Clinic 1a University of Minnesota Physicians
Minneapolis, MN 55455
Mailing address
420 Delaware Street SE
MMC 297 University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 625-2661
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2T420DY | Other | MN | BCBS |
| 23-24496 | Other | MN | MEDICA CHOICE |
| 075203700 | Medicaid | MN | |
| 1009089 | Other | MN | PREFERRED ONE |
| 609344 | Other | MN | ARAZ |
| 101455 | Other | MN | UCARE |
| 23-00008 | Other | MN | MEDICA PRIMARY |
| HP22113 | Other | MN | HEALTHPARTNERS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351123200000",
"number": "1376571950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE STREET SE",
"address_2": "MMC 297 UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-625-2661",
"fax_number": "612-624-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE STREET SE",
"address_2": "PWB 1ST FL CLINIC 1A UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "DENNIS",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2012-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "26055",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MN",
"license": "26055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2T420DY",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "23-24496",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "075203700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1009089",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "609344",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "101455",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PRIMARY",
"identifier": "23-00008",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP22113",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.