NPIMap

Individual provider Active NPI

Phyllis Noss, M.D.

  • Diagnostic Radiology Physician
  • Duluth, MN
National Provider Identifier
1487745253
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MN44231 Issued in MN
Practice address
1924 Dunedin Ave
Duluth, MN 55803-2400
Phone
(218) 724-6083
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MN44231 MN Primary
Diagnostic Radiology Physician 2085R0202X 44321 MN

Addresses

Primary practice location

1924 Dunedin Ave
Duluth, MN 55803-2400

Mailing address

1200 E 25TH St
Hibbing, MN 55746-3897
Phone (218) 312-3002

Other practice location 1

4572 County Road 61
Moose Lake, MN 55767-9401
Phone (218) 312-3002

Other identifiers 5

IdentifierTypeStateIssuer
1602543OtherMNMEDICA
164104OtherMNUCARE
H100320262OtherMNMEDICARE
P00043495OtherMNRAILROAD MEDICARE
087K5NOOtherMNBLUE CROSS BLUE SHIELD

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
I20040228000074 MN Practitioner - Diagnostic Radiology 2769379411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4572 County Rd
Suite 61
Moose Lake, MN 55767-9401
Phone (218) 485-5578

Hospital & facility affiliations

  • Essentia Health Moose Lake Hospital, Moose Lake, MN, CCN 241350
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Essentia Health Sandstone Hospital, Sandstone, MN, CCN 241309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44321MNMDDiagnostic Radiology Physician
MN44231MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
P J Noss Corporation Diagnostic Radiology CurrentSince Aug 1, 2016 Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
PJ Noss LLC Diagnostic Radiology PastSince Apr 11, 2003 Accepting new patients

Locations

1200 E 25th St
Hibbing, MN 55746
Phone (218) 312-3002

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

Organizations & group practices 3

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 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487745253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E 25TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463897",
            "telephone_number": "218-312-3002",
            "fax_number": "218-263-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 DUNEDIN AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558032400",
            "telephone_number": "218-724-6083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4572 County Road 61",
            "address_purpose": "LOCATION",
            "city": "Moose Lake",
            "state": "MN",
            "postal_code": "557679401",
            "country_code": "US",
            "telephone_number": "218-312-3002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOSS",
        "first_name": "PHYLLIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "MN44231",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "44321",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1602543",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "164104",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H100320262",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00043495",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "087K5NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.