Active NPI
Mark William Yeazel, M.D.
- Family Medicine Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 31743
- Practice address
- 1020 West Broadway
Minneapolis, MN 55411 - Phone
- (612) 302-8200
- Fax
- (612) 302-8275
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31743 | MN | Primary |
Addresses
Primary practice location
1020 West Broadway
Minneapolis, MN 55411
Mailing address
720 Washignton Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone (612) 884-0649
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092585 | Other | MN | FAIRVIEW |
| 570002700 | Medicaid | MN | |
| 01-03328 | Other | MN | MEDICA - CHOICE |
| 100588 | Other | MN | UCARE |
| 58D72YE | Other | MN | BLUE CROSS BLUE SHIELD |
| HP17443 | Other | MN | HEALTHPARTNERS |
| 1009362 | Other | MN | PREFERREDONE |
| 768420 | Other | MN | ARAZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 86.67 of 100
- 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 Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients |
Locations
1020 W Broadway Ave
Minneapolis, MN 55411
Phone (612) 302-8200
420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769
Interoperability endpoints
- myeazel1981@direct.northmemorial.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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335139200000",
"number": "1619061124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 WASHIGNTON AVE SE",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55414",
"telephone_number": "612-884-0649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 WEST BROADWAY",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55411",
"telephone_number": "612-302-8200",
"fax_number": "612-302-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEAZEL",
"first_name": "MARK",
"middle_name": "WILLIAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2012-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "31743",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAIRVIEW",
"identifier": "092585",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "570002700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA - CHOICE",
"identifier": "01-03328",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "100588",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "58D72YE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP17443",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1009362",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "768420",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.