Active NPI
Ian Mitchell
- Anesthesiology Physician
- Plymouth, MN
National Provider Identifier
1780119677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 69265
- Practice address
- 14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876 - Phone
- (763) 559-3779
- NPI assigned
- Apr 27, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 70226-20 | WI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 69265 | MN | Primary |
Addresses
Primary practice location
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Mailing address
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000
Hospital & facility affiliations
- Allina United Hospital
- M Health Fairview Woodwinds Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70226-20 | WI | MD | Anesthesiology Physician |
| 6706 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Anesthesia Network, LLP | Anesthesiology | Current | Accepting new patients |
| University Anesthesia Providers, LLC | Anesthesiology | Current | Accepting new patients |
Locations
500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
-
- Anesthesiology Physician
- Minneapolis, MN
- NPI 1699711143
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1457319485
-
- General Acute Care Hospital
- Hastings, MN
- NPI 1508457045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738886400000",
"number": "1780119677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14700 28TH AVE N STE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14700 28TH AVE N STE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474876",
"telephone_number": "763-559-3779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2025-02-07",
"certification_date": "2025-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "70226-20",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MN",
"license": "69265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.