NPIMap

Individual provider Active NPI

Daniel Fellows Pease, M.D.

  • Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1396035176
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
58434 Issued in MN
Practice address
701 Park Avenue
Mail Code G5
Minneapolis, MN 55415
Phone
(612) 873-2705
Fax
(612) 904-4366
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 58434 MN Primary
Internal Medicine Physician 207R00000X 107519 MN

Addresses

Primary practice location

701 Park Avenue
Mail Code G5
Minneapolis, MN 55415

Mailing address

701 Park Avenue
Mail Code G5
Minneapolis, MN 55415
Phone (612) 873-2705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140707001959 MN Practitioner - Hematology/Oncology 1658596630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3435 W Broadway Ave
Robbinsdale, MN 55422-2969
Phone (763) 581-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58434MNMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Mar 24, 2017 Accepting new patients
North Memorial Health Care CurrentSince Mar 1, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
North Memorial Health Care CurrentSince Mar 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Mar 24, 2017 Accepting new patients

Locations

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

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

3435 W Broadway Ave
Robbinsdale, MN 55422
Phone (763) 520-7887

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: dpease166317@direct.northmemorial.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1396035176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVENUE",
            "address_2": "MAIL CODE G5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-873-2705",
            "fax_number": "612-904-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVENUE",
            "address_2": "MAIL CODE G5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-873-2705",
            "fax_number": "612-904-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASE",
        "first_name": "DANIEL",
        "middle_name": "FELLOWS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "58434",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "107519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.