NPIMap

Individual provider Active NPI

Mark R. Nielsen, MD

  • Internal Medicine Physician
  • Bloomington, MN
National Provider Identifier
1609830843
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35777 Issued in MN
Practice address
600 W 98TH St
Bloomington, MN 55420-4773
Phone
(952) 885-6060
NPI assigned
Apr 14, 2006
Last updated
May 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35777 MN Primary

Addresses

Primary practice location

600 W 98TH St
Bloomington, MN 55420-4773

Mailing address

600 W 98TH St
Bloomington, MN 55420-4773

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
I20050701000901 MN Practitioner - Internal Medicine 1850337502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

15650 Cedar Ave
Apple Valley, MN 55124-7283
Phone (952) 997-4100

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 881-2651

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35777MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 19, 2009 Accepting new patients
Fairview Clinics CurrentSince Oct 19, 2009 Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

Interoperability endpoints

  • Direct secure messaging: mnielsen3784@fairview.direct-ci.com

Organizations & group practices 3

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 8

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1609830843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204773",
            "telephone_number": "952-885-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "MARK",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "35777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.