Individual provider Active NPI

Ann T McIntosh, MD

  • Emergency Medicine Physician
  • St Louis Park, MN
National Provider Identifier
1487615100
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
42696 Issued in MN
Practice address
6500 Excelsior Blvd
Methodist Hospital
St Louis Park, MN 55426
Phone
(952) 993-6080
Fax
(952) 993-6047
NPI assigned
Mar 31, 2006
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 42696 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
Methodist Hospital
St Louis Park, MN 55426

Mailing address

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

Other practice location 1

1815 Wisconsin Ave
Benson, MN 56215-1653
Phone (320) 843-2030

Other identifiers 2

IdentifierTypeStateIssuer
410662800MedicaidMN
42696OtherMNMN MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amcintosh566644@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100603000905 MN Practitioner - Emergency Medicine 4688703457 Reassigns benefits to 7 organizations
I20180629001274 AZ Practitioner - Emergency Medicine 4688703457 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42696MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Meeker CurrentSince Aug 15, 2018 Accepting new patients
Carris Health LLC Emergency Medicine CurrentSince Feb 28, 2018 Accepting new patients
Swift County Benson Hospital CurrentSince Oct 15, 2015 Accepting new patients
Swift County-Benson Hospital CurrentSince Oct 15, 2015 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince May 20, 2018 Accepting new patients
Winona Health Services CurrentSince Dec 1, 2015 Accepting new patients
Johnson Memorial Health Services CurrentSince Nov 17, 2022 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Dec 7, 2016 Accepting new patients
Carris Health LLC CurrentSince Feb 28, 2018 Accepting new patients
Healtheast St. John's Hospital CurrentSince Dec 12, 2016 Accepting new patients
Emergency Professional Services PC Emergency Medicine Current Accepting new patients
Johnson Memorial Health Services Current Accepting new patients
Johnson Memorial Health Services CurrentSince Nov 17, 2022 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince May 20, 2018 Accepting new patients
Minnesota Pathologists Chartered Current Accepting new patients
Sibley Medical Center Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 301
Phoenix, AZ 85006
Phone (602) 239-6968

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

1282 Walnut St
Dawson, MN 56232
Phone (320) 769-4323

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: amcintosh566644@direct.centracare.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1487615100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553437983",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "address_2": "METHODIST HOSPITAL",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "952-993-6080",
            "fax_number": "952-993-6047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Benson",
            "state": "MN",
            "postal_code": "562151653",
            "country_code": "US",
            "telephone_number": "320-843-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "ANN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "42696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410662800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAL LICENSE",
            "identifier": "42696",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amcintosh566644@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "amcintosh566644@direct.centracare.com",
            "address_1": "1815 Wisconsin Ave",
            "city": "Benson",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562151653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.