Organization Active NPI

Metropolitan Gastrointestinal Specialists

  • Gastroenterology Physician
  • Maple Grove, MN
National Provider Identifier
1467640482
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
22031 Issued in MN
Legal business name
METROPOLITAN GASTROINTESTINAL SPECIALISTS
Practice address
17322 91St Ave N
Maple Grove, MN 55311-5403
Phone
(612) 414-1033
Fax
(763) 416-4565
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Dr. James Peter Kromhout, M.D.NPI 1720098932
Title
President
Phone
(612) 414-1033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 22031 MN Primary

Addresses

Primary practice location

17322 91St Ave N
Maple Grove, MN 55311-5403

Mailing address

17322 91St Ave N
Maple Grove, MN 55311-5403
Phone (612) 414-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080206000518 MN Part B Supplier - Clinic/Group Practice 5092898585 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1467640482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17322 91ST AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115403",
            "telephone_number": "612-414-1033",
            "fax_number": "763-416-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17322 91ST AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115403",
            "telephone_number": "612-414-1033",
            "fax_number": "763-416-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN GASTROINTESTINAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "KROMHOUT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-414-1033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "22031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.