NPIMap

Individual provider Active NPI

Melissa Gunderson, MD

  • Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1700445301
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
72183 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 495-6600
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT218324 PA
Surgery Physician 208600000X 72183 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

420 Delaware St SE
Mayo Mail Code 195
Minneapolis, MN 55455
Phone (612) 626-2590

Other practice location 1

420 Delaware St SE
Mayo Mail Sto 195
Minneapolis, MN 55455
Phone (612) 626-2590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004003490 MN Practitioner - General Surgery 5698003259 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
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)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-4786

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT218324PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Apr 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2023 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2023 Accepting new patients
Group Health, Inc. CurrentSince Nov 7, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
Group Health, Inc. CurrentSince Nov 7, 2022 Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

420 Delaware St SE
Ste 195
Minneapolis, MN 55455
Phone (612) 301-9433

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Interoperability endpoints

  • Direct secure messaging: mgunderson484197@fairview.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1700445301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MAYO MAIL CODE 195",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-2590"
        },
        {
            "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": "651-495-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_2": "Mayo Mail Sto 195",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55455",
            "country_code": "US",
            "telephone_number": "612-626-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "MELISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT218324",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "72183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.