Active NPI
James Dvorak, M.D.
- Physical Medicine & Rehabilitation Physician
- Saint Louis Park, MN
National Provider Identifier
1649624248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 64568
- Practice address
- 5775 Wayzata Blvd Ste 190
Saint Louis Park, MN 55416-2627 - Phone
- (952) 541-1840
- Fax
- (952) 543-6524
- NPI assigned
- Apr 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pain Medicine Physician | 208VP0000X | 64568 | MN | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 64568 | MN | Primary |
Addresses
Primary practice location
5775 Wayzata Blvd Ste 190
Saint Louis Park, MN 55416-2627
Mailing address
PO Box 1450 NW 6035
Minneapolis, MN 55485-1450
Phone (866) 674-7933
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64568 | MN | MD | Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cdi Twin Cities ASC LLC | Current | Accepting new patients | |
| Medical Scanning Consultants PA | Current | Accepting new patients | |
| Medical Scanning Consultants PA | Current | Accepting new patients |
Locations
5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338
5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338
Organizations & group practices 3
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.
-
- Diagnostic Radiology Physician
- St Louis Park, MN
- NPI 1659348092
-
- Ambulatory Surgical Clinic/Center
- St Louis Park, MN
- NPI 1245207687
-
- Diagnostic Radiology Physician
- Federal Way, WA
- NPI 1730156175
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1649624248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1450 NW 6035",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554851450",
"telephone_number": "866-674-7933",
"fax_number": "952-513-6880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5775 WAYZATA BLVD STE 190",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554162627",
"telephone_number": "952-541-1840",
"fax_number": "952-543-6524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DVORAK",
"first_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-20",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "MN",
"license": "64568",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MN",
"license": "64568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.