Northern Cardiovascular Clinic, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NORTHERN CARDIOVASCULAR CLINIC, PA

Practice address

6565 France Ave S Ste 101
Edina, MN 55435-2154

Phone

(952) 500-0653

Fax

(952) 892-0254

NPI assigned

Apr 22, 2020

Last updated

Apr 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dominic A Plucinski, MDNPI 1902856974

Title

President

Phone

(763) 229-4006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dominic Anthony Plucinski, MD

  • Cardiovascular Disease Physician
  • Edina, MN
  • NPI 1902856974
  Medicare reassignment NPD Authorized official
• Shannon Olson, FNP

  • Family Nurse Practitioner
  • Minneapolis, MN
  • NPI 1154887214
  NPD
• Gregory L Miller, DO

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1821040783
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1639799323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 101",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352154",
            "telephone_number": "952-500-0653",
            "fax_number": "952-892-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 101",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352154",
            "telephone_number": "952-500-0653",
            "fax_number": "952-892-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CARDIOVASCULAR CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "PLUCINSKI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-229-4006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Sheloa Nornes, PA-C
• Sara Norseng, W.H.N.P.
• North Star Eye Associates
• North Star Metabolic & Performance
• North Star MPC LLC
• Northern Veins, P.a.
• Northland Dental Partners, PLLC (Dentistry on 77th)
• Northstar Dentistry (The Dentist's House of Edina)
• Northstar Therapy Services LLC
• Northway Academy, Inc.

• Clinic/Center in Edina, MN
• Providers in Edina, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.