NPIMap

Organization Active NPI

University of Minnesota

  • Neuromusculoskeletal Medicine & OMM Physician
  • Minneapolis, MN
National Provider Identifier
1518445691
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
Legal business name
UNIVERSITY OF MINNESOTA
Practice address
515 Delaware St. SE
Moos Tower, Room 13-129
Minneapolis, MN 55455
Phone
(612) 626-7403
Fax
(612) 301-1455
NPI assigned
Aug 1, 2018
Last updated
Aug 1, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF MINNESOTA (NEUROLOGY)As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Dr. Jerrold Lee Vitek, M.D.
Title
Chair, Neurology Dept.
Phone
(612) 625-5993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X NU Primary

Addresses

Primary practice location

515 Delaware St. SE
Moos Tower, Room 13-129
Minneapolis, MN 55455

Mailing address

420 Delaware St. SE
Mmc295 Mayo
Minneapolis, MN 55455
Phone (612) 626-4703

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0927621University of Minnesota Neuromuscular515 Delaware St SE Room 13-129, Minneapolis, MN 55455ComplianceJan 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Comm-Univ HLTH Care Psy33 organizations share this tax ID, including this one
Part of
Comm-Univ HLTH Care Psy

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

420 Delaware St SE
#295
Minneapolis, MN 55455
Phone (612) 625-6519

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1518445691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST. SE",
            "address_2": "MMC295 MAYO",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-4703",
            "fax_number": "612-301-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST. SE",
            "address_2": "MOOS TOWER, ROOM 13-129",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-7403",
            "fax_number": "612-301-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MINNESOTA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF MINNESOTA (NEUROLOGY)",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "VITEK",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHAIR, NEUROLOGY DEPT.",
        "authorized_official_telephone_number": "612-625-5993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.