NPIMap

Individual provider Active NPI

Themistocles Peter Economou, M.D.

  • Plastic Surgery Physician
  • Bloomington, MN
National Provider Identifier
1528152170
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
37341 Issued in MN
Practice address
7760 France Ave S Ste 1000
Bloomington, MN 55435-5870
Phone
(952) 746-6767
Fax
(952) 746-6768
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 37341 MN Primary

Addresses

Primary practice location

7760 France Ave S Ste 1000
Bloomington, MN 55435-5870

Mailing address

2550 University Ave W Ste 110N
Saint Paul, MN 55114-2001
Phone (651) 602-5309

Other identifiers 1

IdentifierTypeStateIssuer
384325400MedicaidMN

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
I20101111000940 MN Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 8628974524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
University of Minnesota Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

310 N Smith Ave
Suite 100
Saint Paul, MN 55102-2379
Phone (651) 251-5500

6545 France Ave S
Suite 210
Edina, MN 55435-2281
Phone (952) 928-2900

7760 France Ave S
Suite 1000
Bloomington, MN 55435-5870
Phone (952) 749-6767

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Merit-based Incentive Payment System (MIPS)

Final score
89.19 of 100Reported as apm
Quality
72.34
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision103
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology PA CurrentSince Mar 1, 2017 Accepting new patients
Minnesota Oncology Hematology, PA Current Accepting new patients
Minnesota Oncology Hematology, PA CurrentSince Mar 1, 2017 Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients
Minnesota Oncology Hematology, PA Past Accepting new patients
Plastic Surgery Consultants Plastic Surgery Past Accepting new patients
Plastic Surgery Consultants, LTD. Past Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

7760 France Ave S
Ste 1000
Bloomington, MN 55435
Phone (952) 746-6767

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

Interoperability endpoints

  • Direct secure messaging: sam.economou@moh.ikm.direct-ci.com

Organizations & group practices 7

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1528152170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 110N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551142001",
            "telephone_number": "651-602-5309",
            "fax_number": "651-222-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7760 FRANCE AVE S STE 1000",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355870",
            "telephone_number": "952-746-6767",
            "fax_number": "952-746-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECONOMOU",
        "first_name": "THEMISTOCLES",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "37341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384325400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.