Individual provider Active NPI

Patrick J Flynn, M.D.

  • Hematology & Oncology Physician
  • Woodbury, MN
National Provider Identifier
1619938222
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
23037 Issued in MN
Practice address
6025 Lake Rd
Ste 110
Woodbury, MN 55125-1709
Phone
(651) 735-7414
Fax
(651) 735-7414
NPI assigned
Mar 31, 2006
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 23037 MN Primary

Addresses

Primary practice location

6025 Lake Rd
Ste 110
Woodbury, MN 55125-1709

Mailing address

6025 Lake Rd
Ste 110
Woodbury, MN 55125-1709
Phone (651) 735-7414

Other identifiers 9

IdentifierTypeStateIssuer
30613600MedicaidWI
8T402FLOtherMNBLUE CROSS BLUE SHIELD MN
3600777OtherMNMEDICA
396085400MedicaidMN
0003690OtherMNPREFERRED ONE
1106312OtherMNUCARE MN
23323OtherMNAMERICA'S PPO
HP13298OtherMNHEALTHPARTNERS
406272800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology, PA Hematology & Oncology Past Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients
Minnesota Oncology Hematology, PA Hematology & Oncology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1619938222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 LAKE RD",
            "address_2": "STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251709",
            "telephone_number": "651-735-7414",
            "fax_number": "651-735-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 LAKE RD",
            "address_2": "STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251709",
            "telephone_number": "651-735-7414",
            "fax_number": "651-735-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "23037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30613600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "8T402FL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "3600777",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396085400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "0003690",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "1106312",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "23323",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP13298",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406272800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.