Individual provider Active NPI

Mary I Pukite, M.D.

  • Obstetrics & Gynecology Physician
  • Minneapolis, MN
National Provider Identifier
1447204078
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
48510 Issued in MN
Practice address
606 24TH Ave S
Minneapolis, MN 55454-1455
Phone
(612) 273-7111
Fax
(612) 273-7112
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 48510 MN Primary

Addresses

Primary practice location

606 24TH Ave S
Minneapolis, MN 55454-1455

Mailing address

University of Minnesota Physicians
420 Delaware St SE, MMC 395
Minneapolis, MN 55455
Phone (612) 626-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000020 MN Practitioner - Obstetrics/Gynecology 7517966187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Minnesota Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48510MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 1, 2017 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 1, 2017 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Sep 10, 2017 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

6545 France Ave S
Ste 250
Edina, MN 55435
Phone (952) 836-3600

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

606 24th Ave S
Minneapolis, MN 55454
Phone (612) 273-3332

420 Delaware St SE
#395
Minneapolis, MN 55455
Phone (612) 301-3417

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

Interoperability endpoints

  • Direct secure messaging: mpukite9546@fairview.direct-ci.com

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 3

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447204078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "address_2": "420 DELAWARE ST SE, MMC 395",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 24TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541455",
            "telephone_number": "612-273-7111",
            "fax_number": "612-273-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUKITE",
        "first_name": "MARY",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "48510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.