NPIMap

Individual provider Active NPI

Samir Ashwin Joshi, MD

  • Sports Medicine (Family Medicine) Physician
  • Bloomington, MN
National Provider Identifier
1407386881
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
68621 Issued in MN
Practice address
8100 Northland Dr
Bloomington, MN 55431-4800
Phone
(952) 831-8742
Fax
(952) 831-1626
NPI assigned
Jun 18, 2017
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53620 KY
Family Medicine Physician 207Q00000X 68621 MN
Sports Medicine (Family Medicine) Physician 207QS0010X 68621 MN Primary

Addresses

Primary practice location

8100 Northland Dr
Bloomington, MN 55431-4800

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900

Other practice location 2

14050 Fairview Dr
Burnsville, MN 55337-4571
Phone (952) 831-8742

Other identifiers 2

IdentifierTypeStateIssuer
7100687820MedicaidKY
300042832MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200901002338 KY Practitioner - Family Practice 1456620848 Reassigns benefits to 1 organization
I20210713001840 MN Practitioner - Family Practice 1456620848 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Dec 11, 2023 Accepting new patients
North Clinic, PA Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
North Clinic, PA Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Dec 11, 2023 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 100
Louisville, KY 40202
Phone (502) 587-8222

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

9825 Hospital Dr
Ste 300
Maple Grove, MN 55369
Phone (763) 494-7500

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

Organizations & group practices 8

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.

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1407386881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 NORTHLAND DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314800",
            "telephone_number": "952-831-8742",
            "fax_number": "952-831-1626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9825 Hospital Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694768",
            "country_code": "US",
            "telephone_number": "763-587-7900",
            "fax_number": "763-494-7501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14050 Fairview Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374571",
            "country_code": "US",
            "telephone_number": "952-831-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSHI",
        "first_name": "SAMIR",
        "middle_name": "ASHWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "53620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "68621",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "68621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100687820",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300042832",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.