Individual provider Active NPI

Daniel Peter Sipple, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Edina, MN
National Provider Identifier
1699989731
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
53652 Issued in MN
Practice address
7373 France Ave S Ste 408
Edina, MN 55435-4549
Phone
(651) 430-3800
Fax
(651) 430-3827
NPI assigned
May 9, 2007
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 46488 CO
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 54993-021 WI
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 46488 CO
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 53652 MN Primary

Addresses

Primary practice location

7373 France Ave S Ste 408
Edina, MN 55435-4549

Mailing address

1950 Northwestern Ave
Suite 102
Stillwater, MN 55082-7615
Phone (651) 430-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsipple178335@excellian.direct.allina.com Direct

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
I20110808000446 MN Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 9638279573 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46488COMDPain Medicine (Physical Medicine & Rehabilitation) Physician
54993-021WIMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Dec 24, 2016 Accepting new patients
Fairview Health Services CurrentSince Dec 24, 2016 Accepting new patients
Pain Clinic of Northwestern Wisconsin SC Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1699989731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 NORTHWESTERN AVE",
            "address_2": "SUITE 102",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827615",
            "telephone_number": "651-430-3800",
            "fax_number": "651-430-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 408",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354549",
            "telephone_number": "651-430-3800",
            "fax_number": "651-430-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPPLE",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "46488",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WI",
            "license": "54993-021",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "46488",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MN",
            "license": "53652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsipple178335@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "7373 France Ave S Ste 408",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554354549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.