Active NPI
Joseph F Bocklage, M.D.
- Orthopaedic Surgery Physician
- Robbinsdale, MN
National Provider Identifier
1639180417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 18979
- Practice address
- 3366 Oakdale Ave N
Suite 103
Robbinsdale, MN 55422-2948 - Phone
- (763) 520-7870
- Fax
- (763) 520-7580
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 18979 | MN | Primary |
Addresses
Primary practice location
3366 Oakdale Ave N
Suite 103
Robbinsdale, MN 55422-2948
Mailing address
6465 Wayzata Blvd
Suite 900
St Louis Park, MN 55426-1728
Phone (952) 512-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 478277100 | Medicaid | MN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18979 | MN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Health Collaborative, PA | Orthopaedic Surgery | Past | Accepting new patients |
| Infinite Health Collaborative, PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
- Durable Medical Equipment & Medical Supplies
- River Falls, WI
- NPI 1144608589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639180417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6465 WAYZATA BLVD",
"address_2": "SUITE 900",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261728",
"telephone_number": "952-512-5600",
"fax_number": "952-512-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3366 OAKDALE AVE N",
"address_2": "SUITE 103",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222948",
"telephone_number": "763-520-7870",
"fax_number": "763-520-7580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCKLAGE",
"first_name": "JOSEPH",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "18979",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "478277100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.