Individual provider Active NPI

Gary Paul Foley

  • Emergency Medicine Physician
  • Duluth, MN
National Provider Identifier
1457383093
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
40271 Issued in MN
Practice address
407 E 3Rd St
Duluth, MN 55805-1950
Phone
(218) 786-4000
NPI assigned
Jul 6, 2006
Last updated
Jun 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 40271 MN Primary

Addresses

Primary practice location

407 E 3Rd St
Duluth, MN 55805-1950

Mailing address

407 E 3Rd St
Duluth, MN 55805-1950
Phone (218) 786-4000

Other identifiers 1

IdentifierTypeStateIssuer
603016500MedicaidMN

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
I20060112000201 MN Practitioner - Emergency Medicine 5991728214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40271MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Pines Medical Center CurrentSince Feb 18, 2013 Accepting new patients
Northern Pines Medical Center CurrentSince Feb 18, 2013 Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1457383093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "GARY",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "40271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603016500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.