Individual provider Active NPI

Tate Alan Gisslen, MD

  • Neonatal-Perinatal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1629269121
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
106856 Issued in MN
Practice address
2450 Riverside Ave
University of Minnesota Amplatz Children's Hospital
Minneapolis, MN 55454-1450
Phone
(612) 672-6000
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 106856 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
University of Minnesota Amplatz Children's Hospital
Minneapolis, MN 55454-1450

Mailing address

720 Washington Ave SE, Suite 300
University of Minnesota Physicians
Minneapolis, MN 55414-2940

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
I20130717000805 MN Practitioner - Pediatric Medicine 1254513724 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106856MNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Dec 12, 2024 Accepting new patients
Childrens Health Care CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 12, 2024 Accepting new patients
Fairview Clinics CurrentSince May 21, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Jul 1, 2013 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2013 Accepting new patients
Fairview Clinics CurrentSince May 21, 2021 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2013 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Childrens Health Care Current Accepting new patients
Childrens Health Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 28, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 28, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

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

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2025 E River Rd
Minneapolis, MN 55414
Phone (612) 301-0115

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Interoperability endpoints

  • Direct secure messaging: tgisslen41231@fairview.direct-ci.com

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1629269121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE, SUITE 300",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "UNIVERSITY OF MINNESOTA AMPLATZ CHILDREN'S HOSPITAL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-672-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISSLEN",
        "first_name": "TATE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "106856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.