NPIMap

Individual provider Active NPI

Mark Dominic Stephany, D.O.

  • Internal Medicine Physician
  • Coon Rapids, MN
National Provider Identifier
1437386026
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54280 Issued in MN
Practice address
4050 Coon Rapids Blvd NW
Mercy Hospital
Coon Rapids, MN 55433-2522
Phone
(763) 236-6000
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 54280 MN Primary

Addresses

Primary practice location

4050 Coon Rapids Blvd NW
Mercy Hospital
Coon Rapids, MN 55433-2522

Mailing address

4050 Coon Rapids Blvd NW
Mercy Hospital
Coon Rapids, MN 55433-2522

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
I20111230000349 MN Practitioner - Internal Medicine 1850567579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (763) 688-8700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54280MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Nov 29, 2011 Accepting new patients
Allina Health System CurrentSince Jul 1, 2012 Accepting new patients
Allina Health System CurrentSince Sep 1, 2025 Accepting new patients
Allina Health System CurrentSince Jul 1, 2012 Accepting new patients
Fairview Express Care CurrentSince Nov 29, 2011 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Health Services Current Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

1285 Nininger Rd
Hastings, MN 55033
Phone (651) 480-4200

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

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

Organizations & group practices 11

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1437386026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "address_2": "MERCY HOSPITAL",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "address_2": "MERCY HOSPITAL",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHANY",
        "first_name": "MARK",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "54280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.