Individual provider Active NPI

Thomas M Hetzel, MD

  • Emergency Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1699870253
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
37011 Issued in MN
Practice address
2525 Chicago Avenue South
Childrens Hospital and Clinics Emergency Physicians MPL
Minneapolis, MN 55404
Phone
(612) 813-6111
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37011 MN Primary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 37011 MN
Pediatrics Physician 208000000X 37011 MN
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 37011 MN

Addresses

Primary practice location

2525 Chicago Avenue South
Childrens Hospital and Clinics Emergency Physicians MPL
Minneapolis, MN 55404

Mailing address

2910 Centre Pointe Drive
35-121A
Roseville, MN 55113
Phone (651) 855-2109

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
I20150512003076 MN Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5890015986 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37011MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Feb 1, 2015 Accepting new patients
Childrens Health Care CurrentSince Feb 1, 2015 Accepting new patients
Childrens Health Care Pediatrics Current Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1699870253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DRIVE",
            "address_2": "35-121A",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2109",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVENUE SOUTH",
            "address_2": "CHILDRENS HOSPITAL AND CLINICS EMERGENCY PHYSICIANS MPL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZEL",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "37011",
            "primary": true
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MN",
            "license": "37011",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "37011",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MN",
            "license": "37011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.