Stanley J. Antolak Jr. MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

16329 Issued in MN

Legal business name

STANLEY J. ANTOLAK JR. MD PA

Practice address

8650 Hudson Blvd N
Suite 325
Lake Elmo, MN 55042-9747

Phone

(651) 735-9355

Fax

(651) 735-0726

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stanley J Antolak Jr., MDNPI 1881663169

Title

President

Phone

(651) 735-9355

Specialties & licenses 1

Addresses

Other names 1

• Center for Urologic and Pelvic Pain Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanley John Antolak Jr., M.D.

  • Urology Physician
  • Minneapolis, MN
  • NPI 1881663169
  NPD (past) Authorized official

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508930512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 HUDSON BLVD N",
            "address_2": "SUITE 325",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429747",
            "telephone_number": "651-735-9355",
            "fax_number": "651-735-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 HUDSON BLVD N",
            "address_2": "SUITE 325",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429747",
            "telephone_number": "651-735-9355",
            "fax_number": "651-735-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY J. ANTOLAK JR. MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANTOLAK",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-735-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "16329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Urologic and Pelvic Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Croix Valley Dental PLLC
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• St. Croix Anesthesia Associates, P.a.
• St. Croix Counseling
• St. Croix Orthopaedics, P.a.
• Steady Strides LLC
• Laurie Lee Stodola, D.D.S.
• Hannah Strom, PT
• Alison Mae Stroobants, MPS, LPCC, LADC
• Sututa Home Healthcare Services LLC

• Specialist in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.