NPIMap

Organization Active NPI

Mincep Epilepsy Care PA

Doing business as Minnesota Comprehensive Epilepsy Program, P.A.

  • Neurology Physician
  • St Louis Park, MN
National Provider Identifier
1730211863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MINCEP EPILEPSY CARE PA
Doing business as
Minnesota Comprehensive Epilepsy Program, P.A.
Practice address
5775 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-1222
Phone
(952) 525-4511
Fax
(952) 525-1560
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Gumnit
Title
President, Medical Director
Phone
(952) 525-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

5775 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-1222

Mailing address

5775 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-1222
Phone (952) 525-4511

Other identifiers 1

IdentifierTypeStateIssuer
103730OtherMNU CARE NUMBER

Other names 1

  • Minnesota Comprehensive Epilepsy Program, P.A. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730211863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "952-525-4511",
            "fax_number": "952-525-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "952-525-4511",
            "fax_number": "952-525-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINCEP EPILEPSY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUMNIT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "952-525-4511",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE NUMBER",
            "identifier": "103730",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnesota Comprehensive Epilepsy Program, P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.