NPIMap

Individual provider Active NPI

Charles Marquardt, MD

  • Vascular Surgery Physician
  • Coon Rapids, MN
National Provider Identifier
1477180115
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
80797 Issued in MN
Practice address
4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568
Phone
(763) 427-9980
Fax
(763) 427-0904
NPI assigned
Mar 24, 2020
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 80797 MN Primary

Addresses

Primary practice location

4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568

Mailing address

2955 Xenium LN N
Plymouth, MN 55441-2666
Phone (763) 398-6383

Other practice location 1

2955 Xenium Ln N
Plymouth, MN 55441-2666
Phone (763) 398-6383

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlesmarquardt@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912002256 MN Practitioner - Vascular Surgery 1658874847 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Radiology Associates LTDGroup PAC ID 5698661007, 44 clinicians
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2800 Campus Dr
Suite 20
Plymouth, MN 55441-2669
Phone (763) 398-6363

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-4897

4040 Coon Rapids Blvd NW
Suite 120
Coon Rapids, MN 55433-4568
Phone (763) 427-9980

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80797MNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Imaging, LLC CurrentSince Sep 1, 2025 Accepting new patients
Allina Health System CurrentSince Sep 22, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Minnesota Vascular Surgery Center CurrentSince Sep 1, 2025 Accepting new patients
North Memorial Health Care CurrentSince Sep 1, 2025 Accepting new patients
North Memorial Health Care Current Accepting new patients
Minneapolis Radiology Associates, LTD. CurrentSince Sep 1, 2025 Accepting new patients
Minnesota Diagnostic Imaging Partners, LLC CurrentSince Sep 1, 2025 Accepting new patients
Allina Health System CurrentSince Sep 22, 2025 Accepting new patients
North Memorial Health Care CurrentSince Sep 1, 2025 Accepting new patients

Locations

9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

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

4040 Coon Rapids Blvd NW
Ste 120
Minneapolis, MN 55433
Phone (763) 427-9980

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-2203

2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700

2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-2203

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

600 County Road D W
Ste 2
Saint Paul, MN 55112
Phone (763) 432-4300

Interoperability endpoints

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

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477180115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 XENIUM LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412666",
            "telephone_number": "763-398-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW STE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334568",
            "telephone_number": "763-427-9980",
            "fax_number": "763-427-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2955 Xenium Ln N",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554412666",
            "country_code": "US",
            "telephone_number": "763-398-6383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "80797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesmarquardt@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4040 Coon Rapids Blvd NW Ste 120",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554334568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.