NPIMap

Individual provider Active NPI

Andrew H Slattengren, DO

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1578503520
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53992 Issued in MN
Practice address
1020 Broadway Ave
Umphysicians Broadway Family Medicine
Minneapolis, MN 55411
Phone
(612) 302-8200
Fax
(612) 302-8275
NPI assigned
Jun 7, 2006
Last updated
Feb 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53992 MN Primary

Addresses

Primary practice location

1020 Broadway Ave
Umphysicians Broadway Family Medicine
Minneapolis, MN 55411

Mailing address

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414-2924
Phone (612) 884-0649

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
I20110705000455 MN Practitioner - Family Practice 3476626227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key CorporationGroup PAC ID 9032009238, 53 clinicians

Practice addresses (Care Compare)

1394 Jackson St
Saint Paul, MN 55117-4630
Phone (612) 315-5866

2426 W Broadway Ave
Minneapolis, MN 55411-1735
Phone (612) 302-8200

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0649

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
67.02
Promoting interoperability
99
Improvement activities
40
Cost
73.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53992MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Physicians CurrentSince Jul 29, 2011 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

1020 W Broadway Ave
Minneapolis, MN 55411
Phone (612) 302-8200

2426 W Broadway Ave
Minneapolis, MN 55411
Phone (612) 287-0140

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

Interoperability endpoints

  • Direct secure messaging: aslattengren16740@direct.northmemorial.com

Organizations & group practices 5

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 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1578503520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142924",
            "telephone_number": "612-884-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BROADWAY AVE",
            "address_2": "UMPHYSICIANS BROADWAY FAMILY MEDICINE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55411",
            "telephone_number": "612-302-8200",
            "fax_number": "612-302-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTENGREN",
        "first_name": "ANDREW",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.