Individual provider Active NPI

Randall J Rouse, MD

  • Family Medicine Physician
  • Cambridge, MN
National Provider Identifier
1467460055
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35813 Issued in MN
Practice address
701 Dellwood St S
Cambridge, MN 55008-1920
Phone
(763) 689-8700
Fax
(763) 689-7941
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35813 MN Primary
Emergency Medicine Physician 207P00000X 35813 MN

Addresses

Primary practice location

701 Dellwood St S
Cambridge, MN 55008-1920

Mailing address

2925 Chicago Avenue
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

5435 Feltl Rd
Minnetonka, MN 55343-7983
Phone (952) 835-9880

Other practice location 2

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (763) 689-7700

Other identifiers 1

IdentifierTypeStateIssuer
716870500MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rrouse91439@excellian.direct.allina.com Direct

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
I20100201000755 MN Practitioner - Emergency MedicinePractitioner - Family Practice 7517000474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oral Roberts University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (621) 775-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4739MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association Emergency Medicine Current Accepting new patients
Emergency Physicians Professional Association CurrentSince Jan 1, 2018 Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Allina Health System Family Medicine CurrentSince Apr 8, 2023 Accepting new patients
Emergency Physicians Professional Association CurrentSince Jan 1, 2018 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

5435 Feltl Rd
Minnetonka, MN 55343
Phone (952) 857-1504

Interoperability endpoints

  • Direct secure messaging: rrouse91439@excellian.direct.allina.com

Organizations & group practices 5

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 4

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1467460055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELLWOOD ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081920",
            "telephone_number": "763-689-8700",
            "fax_number": "763-689-7941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5435 Feltl Rd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553437983",
            "country_code": "US",
            "telephone_number": "952-835-9880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Dellwood St S",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MN",
            "postal_code": "550081920",
            "country_code": "US",
            "telephone_number": "763-689-7700",
            "fax_number": "763-689-7941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "RANDALL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "35813",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "35813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716870500",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rrouse91439@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "701 Dellwood St S",
            "city": "Cambridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550081920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

Verify at the official NPI Registry.