Peter Cermak, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20653 Issued in MN

Practice address

Ufp Phalen Village Clinic
1414 Maryland Avenue East
Saint Paul, MN 55106

Phone

(651) 772-3461

Fax

(651) 772-2605

NPI assigned

Jun 26, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609803766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UFP PHALEN VILLAGE CLINIC",
            "address_2": "1414 MARYLAND AVENUE EAST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-772-3461",
            "fax_number": "651-772-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UFP PHALEN VILLAGE CLINIC",
            "address_2": "1414 MARYLAND AVENUE EAST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-772-3461",
            "fax_number": "651-772-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERMAK",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "20653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "04-02443",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "1027633",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "1000614",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE & PRIMARY",
            "identifier": "04-02514",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31320300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42G35CE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440385100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP15990",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cerenity Senior Care
• Cerenity Senior Care (Cerenity Care Center - Marian of Saint Paul)
• Cerenity Senior Care (Cerenity Residence on Humboldt)
• Cerenity-Marian of St. Paul, LLC
• Ericka A Cermak
• Jasmine Ceron
• Chue Ying Cha, DDS
• Yer Ton Cha, D.C.
• Antoine Heni Chaanine, MD
• Jato Ambo Chabsi

• Internal Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.