Active NPI
Tricia JH Hall, DO
- Family Medicine Physician
- Minneapolis, MN
National Provider Identifier
1760442065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 44707
- Practice address
- 1020 Broadway Ave
Umphysicians Broadway Family Medicine
Minneapolis, MN 55411 - Phone
- (612) 302-8200
- Fax
- (612) 302-8275
- NPI assigned
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 47073 | WI | |
| Family Medicine Physician | 207Q00000X | 44707 | MN | Primary |
Addresses
Primary practice location
1020 Broadway Ave
Umphysicians Broadway Family Medicine
Minneapolis, MN 55411
Mailing address
720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone (612) 884-0649
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP36753 | Other | MN | HEALTH PARTNERS |
| 184577200 | Medicaid | MN | |
| 34288800 | Medicaid | WI | |
| 0124778 | Other | MN | MEDICA |
| 2444491 | Other | MN | AMERICA'S PPO |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47073 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1760442065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 WASHINGTON AVE SE",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55414",
"telephone_number": "612-884-0649",
"fax_number": "612-676-8992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 BROADWAY AVE",
"address_2": "UMPHYSICIANS BROADWAY FAMILY MEDICINE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55411",
"telephone_number": "612-302-8200",
"fax_number": "612-302-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "TRICIA",
"middle_name": "JH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "47073",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "44707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP36753",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184577200",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34288800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0124778",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "2444491",
"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 Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.