Organization Active NPI

Minnesota Micro Medicine

  • Health Maintenance Organization
  • Excelsior, MN
National Provider Identifier
1699933390
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
16429 Issued in MN
Legal business name
MINNESOTA MICRO MEDICINE
Practice address
19245 Highway 7
Excelsior, MN 55331-9126
Phone
(952) 474-0434
Fax
(952) 474-0491
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Dr. Gregory Lang Seifert, M.D.
Title
Owner
Phone
(952) 474-0434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 16429 MN Primary

Addresses

Primary practice location

19245 Highway 7
Excelsior, MN 55331-9126

Mailing address

19245 Highway 7
Excelsior, MN 55331-9126
Phone (952) 474-0434

Other identifiers 2

IdentifierTypeStateIssuer
080006598MedicaidMN
569062500MedicaidMN

National Provider Directory

National Provider Directory

Locations

19245 Highway 7
Ste 1
Shorewood, MN 55331
Phone (952) 474-0434

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1699933390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19245 HIGHWAY 7",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553319126",
            "telephone_number": "952-474-0434",
            "fax_number": "952-474-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19245 HIGHWAY 7",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553319126",
            "telephone_number": "952-474-0434",
            "fax_number": "952-474-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA MICRO MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "SEIFERT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-474-0434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MN",
            "license": "16429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080006598",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569062500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.