Individual provider Active NPI

Andrea Jeanne Flom, M.D.

  • Obstetrics & Gynecology Physician
  • Minneapolis, MN
National Provider Identifier
1467429175
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33517 Issued in MN
Practice address
801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500
Phone
(612) 333-2503
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 33517 MN Primary

Addresses

Primary practice location

801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500

Mailing address

801 Nicollet Mall
Suite 400
Minneapolis, MN 55402-2500
Phone (612) 333-2503

Other identifiers 12

IdentifierTypeStateIssuer
110639D686OtherMNU-CARE
FP9041001068OtherMNPREFERRED ONE
0719875OtherMNMEDICA CHOICE
160011189OtherMNRAILROAD MEDICARE
26395OtherMNAMERICA'S PPO
27902FLOtherMNBLUE CROSS BLUE SHIELD
1467429175OtherNPI
31796100MedicaidWI
0700065OtherMNMEDICA DUAL/MEDICARE MA
538800700MedicaidMN
A005OtherMNTRICARE WEST/CHAMPUS
HP13295OtherMNHEALTH PARTNERS

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
I20100921000982 MN Practitioner - Obstetrics/Gynecology 7113075227 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2020 Accepting new patients
Obstetrics and Gynecology Associates, P.a. Obstetrics & Gynecology CurrentSince Jan 1, 2019 Accepting new patients

Locations

305 E Nicollet Blvd
Ste 170
Burnsville, MN 55337
Phone (952) 435-4190

6565 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 806-0011

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

801 Nicollet Mall
Ste 400
Minneapolis, MN 55402
Phone (612) 333-2503

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1467429175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NICOLLET MALL",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022500",
            "telephone_number": "612-333-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NICOLLET MALL",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022500",
            "telephone_number": "612-333-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOM",
        "first_name": "ANDREA",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "33517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "110639D686",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "FP9041001068",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "0719875",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160011189",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "26395",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27902FL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467429175",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31796100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA DUAL/MEDICARE MA",
            "identifier": "0700065",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538800700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST/CHAMPUS",
            "identifier": "A005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP13295",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.