Individual provider Active NPI

David D Stuart, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Minneapolis, MN
National Provider Identifier
1720024409
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
19242 Issued in MN
Practice address
701 Park Ave
S1
Minneapolis, MN 55415-1829
Phone
(612) 873-6800
Fax
(612) 904-4322
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 19242 MN Primary

Addresses

Primary practice location

701 Park Ave
S1
Minneapolis, MN 55415-1829

Mailing address

701 Park Ave
Mail Code G5
Minneapolis, MN 55415-1829
Phone (612) 873-7381

Other identifiers 1

IdentifierTypeStateIssuer
652370600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1720024409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "address_2": "MAIL CODE G5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151829",
            "telephone_number": "612-873-7381",
            "fax_number": "612-904-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "address_2": "S1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151829",
            "telephone_number": "612-873-6800",
            "fax_number": "612-904-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "DAVID",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "19242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "652370600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.