Individual provider Active NPI

David Pautz, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Edina, MN
National Provider Identifier
1689007940
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
24360 Issued in MN
Practice address
6313 Westwood CT
Edina, MN 55436-1149
Phone
(952) 931-9259
NPI assigned
Aug 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 24360 MN Primary

Addresses

Primary practice location

6313 Westwood CT
Edina, MN 55436-1149

Mailing address

6313 Westwood CT
Edina, MN 55436-1149
Phone (952) 931-9259

Other identifiers 1

IdentifierTypeStateIssuer
24360OtherMNMEDICAL LICENSE

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23460MNMDClinical Cardiac Electrophysiology Physician
24360MNMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689007940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 WESTWOOD CT",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361149",
            "telephone_number": "952-931-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6313 WESTWOOD CT",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361149",
            "telephone_number": "952-931-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUTZ",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "24360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "24360",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.