Individual provider Active NPI

Eleanor-Irene B Bucu, MD

  • Pediatrics Physician
  • Eagan, MN
National Provider Identifier
1477528180
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38397 Issued in MN
Practice address
1110 Yankee Doodle Rd
Eagan, MN 55121-2092
Phone
(651) 454-3970
NPI assigned
Feb 17, 2006
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 38397 MN Primary

Addresses

Primary practice location

1110 Yankee Doodle Rd
Eagan, MN 55121-2092

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
469334500MedicaidMN

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
I20071211000207 MN Practitioner - Pediatric Medicine 8426147653 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 31, 2012 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Jan 31, 2012 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

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

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

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

1110 Yankee Doodle Rd
Saint Paul, MN 55121
Phone (651) 454-3970

Interoperability endpoints

  • Direct secure messaging: ebucu94768@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1477528180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "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": "1110 YANKEE DOODLE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212092",
            "telephone_number": "651-454-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCU",
        "first_name": "ELEANOR-IRENE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "38397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469334500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.