NPIMap

Individual provider Active NPI

Raymond John Poor, M.D.

  • Nephrology Physician
  • Roseville, MN
National Provider Identifier
1730106576
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
45375 Issued in MN
Practice address
2085 Rice St
Roseville, MN 55113-6807
Phone
(651) 489-9035
Fax
(651) 489-6373
NPI assigned
Jul 17, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 45375 MN Primary

Addresses

Primary practice location

2085 Rice St
Roseville, MN 55113-6807

Mailing address

6200 Shingle Creek Pkwy
Suite 260
Brooklyn Center, MN 55430-2128
Phone (763) 561-5349

Other identifiers 8

IdentifierTypeStateIssuer
1835219OtherMNAMERICA'S PPO
1034201OtherMNPREFERRED ONE
HP37229OtherMNHEALTHPARTNERS
211914500MedicaidMN
34354500MedicaidWI
164081C028OtherUCARE
3100162OtherMNMEDICA
428S0POOtherMNBCBSMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpoor85616@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040702000583 MN Practitioner - NephrologyPractitioner - Internal Medicine 3274510649 Reassigns benefits to 4 organizations
I20250812004234 WI Practitioner - Nephrology 3274510649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regency Hospital of Minneapolis, LLCGroup PAC ID 0345203840, 22 clinicians
Kidney Specialists of Minnesota, PAGroup PAC ID 5092616029, 33 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

1300 Hidden Lakes Pkwy
Golden Valley, MN 55422-4286
Phone (763) 588-2750

2085 Rice St
Roseville, MN 55113-6807
Phone (651) 489-9035

2651 Hillcrest Dr
Suite 302
Hudson, WI 54016-9919
Phone (651) 489-9035

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (866) 603-0016

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

6200 Shingle Creek Pkwy
Suite 250
Brooklyn Center, MN 55430-2107
Phone (763) 544-0696

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 14, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Kidney Specialists of Minnesota, PA Nephrology CurrentSince May 1, 2004 Accepting new patients
Regency Hospital of Minneapolis, LLC CurrentSince Jun 17, 2018 Accepting new patients
North Memorial Health Care CurrentSince Nov 1, 2017 Accepting new patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care CurrentSince Nov 1, 2017 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422
Phone (763) 588-2750

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6200 Shingle Creek Pkwy
Ste 250
Minneapolis, MN 55430
Phone (612) 823-8001

6200 Shingle Creek Pkwy
Ste 260
Minneapolis, MN 55430
Phone (763) 544-0696

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2085 Rice St
Saint Paul, MN 55113
Phone (651) 489-9035

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

Interoperability endpoints

  • Direct secure messaging: rpoor16500@direct.acumenmd.com

Organizations & group practices 8

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.

Hospital & facility affiliations 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1730106576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY",
            "address_2": "SUITE 260",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302128",
            "telephone_number": "763-561-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RICE ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136807",
            "telephone_number": "651-489-9035",
            "fax_number": "651-489-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR",
        "first_name": "RAYMOND",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "45375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1835219",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1034201",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP37229",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211914500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34354500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "164081C028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "3100162",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "428S0PO",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpoor85616@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2085 Rice St",
            "city": "Roseville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551136807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.