Ioannis Pothoulakis, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(651) 254-3456

NPI assigned

Mar 20, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Gastroenterology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regions Hospital Hospital, Saint Paul, MN, CCN 240106

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1245608454
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regions Hospital

  • Pharmacy
  • Saint Paul, MN
  • NPI 1013951748

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  Care Compare affiliation
• Regions Hospital

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1306873872
  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1629006457
  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1679391122
  Care Compare affiliation
• Regions Hospital

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1871929976

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1962149419
  Care Compare affiliation

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1649730375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 IRVING ST. NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-877-8278",
            "fax_number": "202-877-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHOULAKIS",
        "first_name": "IOANNIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew John Portis, M.D.
• Angela Posine, CD(DONA)
• Brian Christopher Post, PH.D.
• Hannah A Post, DMD
• Nancy Ann Potempa, LADC
• Rachel B Potter, LICSW
• Timothy J Potter, MD
• Sarah Lynne Potts, APRN
• Kelly Rose Potz, PHARMD
• Asmita Poudel

• Student in an Organized Health Care Education/Training Program in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2025; 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.

Verify at the official NPI Registry.