Individual provider Active NPI

David Bryan Gremmels, M.D.

  • Pediatric Cardiology Physician
  • St Louis Park, MN
National Provider Identifier
1508813452
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
45722 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-1000
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 45722 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

8170 33Rd Ave S
PO Box 1309 Mail Stop 21110Q
Minneapolis, MN 55425-4516

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 2

IdentifierTypeStateIssuer
737689800MedicaidMN
34387100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 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
I20031125000578 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 8820992357 Reassigns benefits to 7 organizations
I20080616000707 ND Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 8820992357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
University of Chicago, Pritzker School of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Children's Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 291-2848

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45722MNMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Jan 24, 2018 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Childrens Health Care CurrentSince Jan 24, 2018 Accepting new patients
Childrens Health Care Current Accepting new patients
Park Nicollet Clinic CurrentSince Mar 4, 2010 Accepting new patients
Cook County Hospital District CurrentSince Feb 10, 2026 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Mar 16, 2012 Accepting new patients
Innovis Health LLC CurrentSince Mar 10, 2022 Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Jun 1, 2014 Accepting new patients
Lakewood Health System CurrentSince Jan 26, 2024 Accepting new patients
Innovis Health, LLC CurrentSince Mar 10, 2022 Accepting new patients
Lakewood Health System CurrentSince Jan 26, 2024 Accepting new patients
Mayo Clinic CurrentSince Feb 19, 2020 Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Jun 1, 2014 Accepting new patients
Mayo Clinic CurrentSince Feb 19, 2020 Accepting new patients
The Duluth Clinic, LTD CurrentSince Mar 16, 2012 Accepting new patients
Mayo Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince Mar 4, 2010 Accepting new patients
Cook County Hospital District Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404
Phone (612) 813-8800

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

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1508813452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "PO BOX 1309 MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREMMELS",
        "first_name": "DAVID",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "45722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "737689800",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34387100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.