Individual provider Active NPI

Megan Elizabeth Deisz, M.D.

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1629147095
Registry record updated Jan 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
50804 Issued in MN
Practice address
2525 Chicago Ave
Mail Stop 32-B880
Minneapolis, MN 55404-4518
Phone
(612) 813-7188
Fax
(612) 813-5801
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 50804 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Mail Stop 32-B880
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Mail Stop 32-B880
Minneapolis, MN 55404-4518
Phone (612) 813-7188

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090930000659 MN Practitioner - Pediatric Medicine 4385780667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50804MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Pediatrics Current Accepting new patients
Children'S Health Care CurrentSince Jul 24, 2009 Accepting new patients
Childrens Health Care CurrentSince Jul 24, 2009 Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2525 Chicago Ave
Stop 32B880
Minneapolis, MN 55404
Phone (612) 813-7188

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232236800000",
    "number": "1629147095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "address_2": "MAIL STOP 32-B880",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-7188",
            "fax_number": "612-813-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "address_2": "MAIL STOP 32-B880",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-7188",
            "fax_number": "612-813-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEISZ",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "50804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.