Individual provider Active NPI

Cesar Juan Jose Ercole, M.D.

  • Urology Physician
  • Saint Paul, MN
National Provider Identifier
1467449678
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
29699 Issued in MN
Practice address
360 Sherman St
Suite 450
Saint Paul, MN 55102-2564
Phone
(651) 999-6800
Fax
(651) 999-6808
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 29699 MN Primary

Addresses

Primary practice location

360 Sherman St
Suite 450
Saint Paul, MN 55102-2564

Mailing address

2550 University Ave W
Suite 240N
Saint Paul, MN 55114-1052
Phone (651) 999-6909

Other identifiers 1

IdentifierTypeStateIssuer
444287300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29699MNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Urologic Specialists. P.a. Past Accepting new patients

Organizations & group practices 1

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1467449678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 240N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-999-6909",
            "fax_number": "651-297-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SHERMAN ST",
            "address_2": "SUITE 450",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022564",
            "telephone_number": "651-999-6800",
            "fax_number": "651-999-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERCOLE",
        "first_name": "CESAR",
        "middle_name": "JUAN JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "29699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444287300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.