Individual provider Active NPI

Nicholas Neal Holmes, MD

  • Sports Medicine (Family Medicine) Physician
  • Oak Park Heights, MN
National Provider Identifier
1740458835
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
106245 Issued in MN
Practice address
5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Feb 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 106245 MN Primary
Family Medicine Physician 207Q00000X 31006 SC
Family Medicine Physician 207Q00000X 4301090597 MI

Addresses

Primary practice location

5803 Neal Ave N
Oak Park Heights, MN 55082-2177

Mailing address

5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone (651) 439-8807

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120723000772 MN Practitioner - Family PracticePractitioner - Sports Medicine 8628250891 Reassigns benefits to 1 organization
I20181214002322 WI Practitioner - Sports MedicinePractitioner - Family Practice 8628250891

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8325 City Centre Dr
Woodbury, MN 55125-3323
Phone (651) 788-4444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090597MIMDFamily Medicine Physician
31006SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Organizations & group practices 3

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 4

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": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1740458835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "NICHOLAS",
        "middle_name": "NEAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "106245",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "31006",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301090597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park Heights, MN

Sources for this page

Verify at the official NPI Registry.