Individual provider Active NPI

Vincent Alexander Renta IV, MD

  • Student in an Organized Health Care Education/Training Program
  • Saint Paul, MN
National Provider Identifier
1639865140
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
580 Rice St
Saint Paul, MN 55103-2148
Phone
(651) 227-6551
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77826 MN
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

580 Rice St
Saint Paul, MN 55103-2148

Mailing address

580 Rice St
Saint Paul, MN 55103-2148
Phone (651) 227-6551

Other practice location 1

17489 Dodd Blvd
Lakeville, MN 55044-6506
Phone (952) 428-1020

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
I20241022003981 MN Practitioner - Family Practice 5799144358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 528-6999

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Oct 10, 2024 Accepting new patients
Fairview Clinics CurrentSince Oct 10, 2024 Accepting new patients
Fairview Clinics CurrentSince Oct 10, 2024 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 10, 2024 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients

Locations

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

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 6

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1639865140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032148",
            "telephone_number": "651-227-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032148",
            "telephone_number": "651-227-6551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17489 Dodd Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550446506",
            "country_code": "US",
            "telephone_number": "952-428-1020",
            "fax_number": "952-428-1025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENTA",
        "first_name": "VINCENT",
        "middle_name": "ALEXANDER",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "77826",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.