NPIMap

Individual provider Active NPI

Carrie Eckstam, D.O.

  • Family Medicine Physician
  • Bloomington, MN
National Provider Identifier
1780979088
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55268 Issued in MN
Practice address
8600 Nicollet Ave S
Bloomington, MN 55420-2824
Phone
(952) 541-2800
Fax
(952) 886-7015
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55268 MN Primary

Addresses

Primary practice location

8600 Nicollet Ave S
Bloomington, MN 55420-2824

Mailing address

8600 Nicollet Ave S
Mail Stop 31500a
Bloomington, MN 55420-2824
Phone (952) 541-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140911001905 MN Practitioner - Family Practice 7012136757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

4730 Chicago Ave S
Minneapolis, MN 55407-3570
Phone (952) 967-7485

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 1, 2014 Accepting new patients
Group Health, Inc. CurrentSince Sep 1, 2014 Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

Interoperability endpoints

  • Direct secure messaging: ceckstam111620@direct.healthpartners.com

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1780979088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 NICOLLET AVE S",
            "address_2": "MAIL STOP 31500A",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202824",
            "telephone_number": "952-541-2800",
            "fax_number": "952-886-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NICOLLET AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202824",
            "telephone_number": "952-541-2800",
            "fax_number": "952-886-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKSTAM",
        "first_name": "CARRIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.