NPIMap

Individual provider Active NPI

Chanah M Delisle, MD

  • Emergency Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1396772869
Registry record updated Apr 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
40675 Issued in MN
Practice address
333 Smith Ave N
Mail Stop 60241
Saint Paul, MN 55102-2344
Phone
(651) 241-8001
NPI assigned
Jun 28, 2006
Last updated
Apr 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 40675 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Mail Stop 60241
Saint Paul, MN 55102-2344

Mailing address

PO Box 43
Internal Mail Route 10017
Minneapolis, MN 55440-0043
Phone (612) 262-3678

Other identifiers 1

IdentifierTypeStateIssuer
853480200MedicaidMN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regina Medical Center Past Accepting new patients
Baldwin Area Medical Center, Inc. Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients
Emergency Care Consultants, PA Emergency Medicine Past Accepting new patients
Allina Health System Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270166400000",
    "number": "1396772869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "INTERNAL MAIL ROUTE 10017",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "address_2": "MAIL STOP 60241",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "CHANAH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "40675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853480200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.