NPIMap

Individual provider Active NPI

Michael H. Edwards, MD

  • Rheumatology Physician
  • Waconia, MN
National Provider Identifier
1548244221
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
30352 Issued in KY
Practice address
500 S Maple St
Waconia, MN 55387-1752
Phone
(952) 442-2191
Fax
(952) 442-8064
NPI assigned
Dec 6, 2005
Last updated
Oct 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 30352 KY Primary

Addresses

Primary practice location

500 S Maple St
Waconia, MN 55387-1752

Mailing address

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

Other identifiers 1

IdentifierTypeStateIssuer
64303522MedicaidKY

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
I20120809000894 MN Practitioner - RheumatologyPractitioner - Internal Medicine 1850294281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

111 Hundertmark Rd
Suite 115N
Chaska, MN 55318-1584
Phone (952) 442-7820

560 S Maple St
Waconia, MN 55387-1757

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients
Ridgeview Medical Center CurrentSince Aug 1, 2012 Accepting new patients
University Medical Associates Past Accepting new patients
University Medical Services Foundation Inc Past Accepting new patients

Locations

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 115N
Chaska, MN 55318
Phone (952) 361-2450

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

500 S Maple St
Ofc
Waconia, MN 55387

560 S Maple St
Ste 400
Waconia, MN 55387
Phone (952) 442-3188

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1548244221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MICHAEL",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "30352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64303522",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.