NPIMap

Organization Active NPI

Noran Neurological Clinic P.a.

  • Specialist
  • Bloomington, MN
National Provider Identifier
1710098306
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6112100 Issued in MN
Legal business name
NORAN NEUROLOGICAL CLINIC P.A.
Practice address
3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5202
Phone
(612) 879-1000
Fax
(612) 879-9116
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Steven JanousekNPI 1336145051
Title
President
Phone
(612) 879-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 6112100 MN Primary

Addresses

Primary practice location

3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5202

Mailing address

3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5202
Phone (612) 879-1000

Other identifiers 2

IdentifierTypeStateIssuer
6112100OtherMNSTATE TAX ID
884510700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000324 MN Part B Supplier - Clinic/Group Practice 3971497389 Receives reassigned benefits from 161 practitioners
Practice locations: Minneapolis, MN; Saint Paul, MN; Plymouth, MN; Blaine, MN; Bloomington, MN; Lake Elmo, MN; Edina, MN

National Provider Directory

National Provider Directory

Locations

7373 France Ave S
Ste 604
Edina, MN 55435

1655 Beam Ave
Ste 209
Maplewood, MN 55109

910 E 26th St
Ste 210
Minneapolis, MN 55404
Phone (612) 879-1879

2828 Chicago Ave
Ste 200
Minneapolis, MN 55407
Phone (612) 879-1502

2828 Chicago Ave
Ste 320
Minneapolis, MN 55407

3601 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 992-5691

2855 Campus Dr
Ste 570
Plymouth, MN 55441
Phone (763) 553-2073

Practitioners & affiliated clinicians

Practitioners 205

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

View all 205

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1710098306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355202",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355202",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORAN NEUROLOGICAL CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "JANOUSEK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-879-1000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "6112100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID",
            "identifier": "6112100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "884510700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.