Individual provider Active NPI

James H Sullivan, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis Park, MN
National Provider Identifier
1437138278
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
43064 Issued in MN
Practice address
5775 Wayzata Blvd.
Suite 190
Saint Louis Park, MN 55416-2627
Phone
(952) 541-1840
Fax
(952) 513-6880
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 43064 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd.
Suite 190
Saint Louis Park, MN 55416-2627

Mailing address

PO Box 1450 NW 6035
Minneapolis, MN 55485-6035
Phone (800) 634-4064

Other identifiers 1

IdentifierTypeStateIssuer
689492500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IN, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051101000044 MN Practitioner - Diagnostic Radiology 0042124752 Reassigns benefits to 1 organization
I20190108002690 IN Practitioner - Diagnostic Radiology 0042124752 Reassigns benefits to 1 organization
I20251009002973 AZ Practitioner - Diagnostic Radiology 0042124752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, shared by 5 NPIs, 82 clinicians

Practice addresses (Care Compare)

10438 185TH St W
Suite 100
Lakeville, MN 55044-5307
Phone (952) 345-3878

11900 N Penn St
Carmel, IN 46032-4694
Phone (317) 846-0717

15700 37TH Ave N
Suite 100
Plymouth, MN 55446-3663
Phone (952) 541-1840

1790 Beam Ave
Maplewood, MN 55109-1162
Phone (651) 294-4639

1901 Connecticut Ave S
Suite 200
Sartell, MN 56377-2554
Phone (320) 251-0609

2270 Ford Pkwy
Suite 202
Saint Paul, MN 55116-3412
Phone (651) 455-5500

2305 108TH LN NE
Blaine, MN 55449-5222
Phone (763) 278-4429

232 Wentworth Ave E
West St Paul, MN 55118-3525
Phone (651) 209-0219

251 County Rd
120 Suite D
Sartell, MN 56303-4897
Phone (320) 251-0609

2700 Vikings Cir
Suite 110
Eagan, MN 55121-1002
Phone (651) 306-4567

3260 42ND Ave S
Suite 101
Saint Cloud, MN 56301-6251
Phone (320) 251-0609

3833 Coon Rapids Blvd NW
Suite 120
Coon Rapids, MN 55433-2599
Phone (763) 433-2000

5775 Wayzata Blvd
St Louis Park, MN 55416-2627
Phone (952) 541-1840

6025 Lake Rd
Suite 130
Woodbury, MN 55125-1713
Phone (651) 735-1840

6735 W Red Hawk PL
Marana, AZ 85658-5035
Phone (952) 738-4441

675 E Nicollet Blvd
Suite 150
Burnsville, MN 55337-6742
Phone (952) 898-6627

7123 France Ave S
Edina, MN 55435-4304
Phone (952) 345-3838

7151 Marsh Rd
Suite 100
Indianapolis, IN 46278-1631
Phone (317) 580-5880

775 Prairie Ctr Dr
Suite 260
Eden Prairie, MN 55344-7334
Phone (952) 294-8222

8607 E US Hwy 36
Suite 200
Avon, IN 46123-7960
Phone (317) 569-5855

9040 Quaday Ave NE
Suite 100
Otsego, MN 55330-6657
Phone (763) 433-2033

9630 Grove Cir N
Suite 100
Maple Grove, MN 55369-3477
Phone (763) 416-9916

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43064MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Nov 30, 2018 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Aug 29, 2011 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Aug 29, 2011 Accepting new patients
Cdi Twin Cities ASC LLC Current Accepting new patients
Maplewood Imaging Center LLC Diagnostic Radiology PastSince Jan 1, 2008 Accepting new patients
Midwest Radiology Outpatient Imaging, LLC Diagnostic Radiology Past Accepting new patients
Midwest Radiology, PA Diagnostic Radiology Past Accepting new patients

Locations

8607 E US Highway 36
Ste 200
Avon, IN 46123
Phone (317) 569-5855

11900 Pennsylvania St
Ste 202
Carmel, IN 46032
Phone (317) 569-5767

11900 Pennsylvania St
#10
Carmel, IN 46032

11900 Pennsylvania St
Ste 100
Carmel, IN 46032

10206 Lantern Rd
Fishers, IN 46037
Phone (317) 598-1133

521 E County Line Rd
Ste D
Greenwood, IN 46143
Phone (317) 882-9422

7151 Marsh Rd
#100
Indianapolis, IN 46278
Phone (317) 580-5880

1250 N Post Rd
Ste A
Indianapolis, IN 46219
Phone (317) 899-7980

3738 Landmark Dr
Ste D
Lafayette, IN 47905
Phone (765) 449-7984

13436 Tegler Dr
Ste 400
Noblesville, IN 46060
Phone (317) 569-5777

4313 S 7th St
Terre Haute, IN 47802
Phone (812) 234-0555

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338

5775 Wayzata Blvd
Ste 500A
St Louis Park, MN 55416

Organizations & group practices 7

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1437138278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450 NW 6035",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "800-634-4064",
            "fax_number": "952-213-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD.",
            "address_2": "SUITE 190",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162627",
            "telephone_number": "952-541-1840",
            "fax_number": "952-513-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAMES",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "43064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689492500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

Verify at the official NPI Registry.