NPIMap

Individual provider Active NPI

Ryan Taylor Anderson

  • Cardiovascular Disease Physician
  • Duluth, MN
National Provider Identifier
1407387707
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
64049 Issued in MN
Practice address
402 E 2ND St
Duluth, MN 55805-1906
Phone
(218) 786-8364
NPI assigned
Mar 27, 2017
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 64049 MN Primary

Addresses

Primary practice location

402 E 2ND St
Duluth, MN 55805-1906

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20180804000012 MN Practitioner - Internal Medicine 3678843554 Reassigns benefits to 3 organizations
I20231129001047 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3678843554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mayo Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

1600 Saint Johns Blvd
Maplewood, MN 55109-1190

1700 University Ave W
Saint Paul, MN 55104-3727

1875 Woodwinds Dr
Woodbury, MN 55125-2298

1875 Woodwinds Dr
Suite 130
Woodbury, MN 55125-4445
Phone (651) 232-0228

1875 Woodwinds Dr
Suite 240
Woodbury, MN 55125-2517
Phone (651) 326-2328

1925 Woodwinds Dr
Woodbury, MN 55125-4445
Phone (651) 232-0228

45 10TH St W
Saint Paul, MN 55102-1062

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28317MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Essentia Health Virginia, LLC CurrentSince Oct 1, 2023 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 28, 2023 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 28, 2023 Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 28, 2023 Accepting new patients
The Duluth Clinic, LTD CurrentSince Aug 28, 2023 Accepting new patients
St Marys Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Oct 1, 2023 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Nov 15, 2023 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary's Medical Center CurrentSince Oct 1, 2024 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

730 E 34th St
Hibbing, MN 55746
Phone (218) 262-3425

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 7

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1407387707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051906",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RYAN",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "64049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.