Active NPI
Randle Scott Corfman, PH.D, M.D.
- Reproductive Endocrinology Physician
- Maple Grove, MN
National Provider Identifier
1649314584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- 207VE0102X
- Practice address
- 12000 Elm Creek Blvd N
Suite 350
Maple Grove, MN 55369-7073 - Phone
- (763) 494-7700
- Fax
- (763) 494-7706
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | 207VE0102X | MN | Primary |
Addresses
Primary practice location
12000 Elm Creek Blvd N
Suite 350
Maple Grove, MN 55369-7073
Mailing address
12000 Elm Creek Blvd N
Suite 350
Maple Grove, MN 55369-7073
Phone (763) 494-7700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| COR16154 | Other | ND | BCBS-ND PROVIDER # |
| 3D491-MI | Other | MN | BCBS-MN PROVIDER # |
| 3D492 | Other | FM | BCBS-MN PROVIDER NUMBER |
| COR16153 | Other | ND | BCBS-ND PROVIDER NUMBER |
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, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207VE0102X | MN | MD | Reproductive Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649314584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12000 ELM CREEK BLVD N",
"address_2": "SUITE 350",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697073",
"telephone_number": "763-494-7700",
"fax_number": "763-494-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 ELM CREEK BLVD N",
"address_2": "SUITE 350",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697073",
"telephone_number": "763-494-7700",
"fax_number": "763-494-7706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORFMAN",
"first_name": "RANDLE",
"middle_name": "SCOTT",
"credential": "PH.D, M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MN",
"license": "207VE0102X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-ND PROVIDER #",
"identifier": "COR16154",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-MN PROVIDER #",
"identifier": "3D491-MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-MN PROVIDER NUMBER",
"identifier": "3D492",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-ND PROVIDER NUMBER",
"identifier": "COR16153",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, 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.