Individual provider Active NPI

Nicholas Raymond Battis, MD

  • Student in an Organized Health Care Education/Training Program
  • Bloomington, MN
National Provider Identifier
1548010630
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone
(651) 254-1573
NPI assigned
Mar 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8170 33Rd Ave S
Bloomington, MN 55425-4516

Mailing address

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250606002384 MN Order and Referring Only - DermatologyPractitioner - Dermatology 7113437393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35676MNMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1548010630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTIS",
        "first_name": "NICHOLAS",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.