NPIMap

Individual provider Active NPI

Alice Macdonald, MBCHB

  • Family Medicine Physician
  • Eden Prairie, MN
National Provider Identifier
1457771271
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60815 Issued in MN
Practice address
8455 Flying Cloud Dr
Eden Prairie, MN 55344
Phone
(952) 993-7400
NPI assigned
Apr 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 60815 MN Primary

Addresses

Primary practice location

8455 Flying Cloud Dr
Eden Prairie, MN 55344

Mailing address

6600 Excelsior Blvd
Suite 160
St Louis Park, MN 55426-4744
Phone (952) 993-7711

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
I20160805000592 MN Practitioner - Family Practice 8527352095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richfield Medical Group LTDGroup PAC ID 9032154497, 7 clinicians

Practice addresses (Care Compare)

44 W 66TH St
Richfield, MN 55423-2316

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60815MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Medical Group LTD Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Fairview Pharmacy Services LLC Past Accepting new patients

Locations

8455 Flying Cloud Dr
Eden Prairie, MN 55344
Phone (952) 883-9040

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

44 W 66th St
Unit 10
Richfield, MN 55423
Phone (612) 861-1622

6440 Nicollet Ave
Richfield, MN 55423
Phone (612) 210-7494

6600 Excelsior Blvd
Ste 160
St Louis Park, MN 55426
Phone (952) 993-7700

Interoperability endpoints

  • Direct secure messaging: amacdonald690746@fairview.direct-ci.com

Organizations & group practices 4

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 8

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": "1397865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1457771271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD",
            "address_2": "SUITE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264744",
            "telephone_number": "952-993-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 FLYING CLOUD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-993-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "MBCHB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-19",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "60815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.