NPIMap

Individual provider Active NPI

Daniel Bullard, MD

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1790314771
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70107 Issued in MN
Practice address
2800 Chicago Ave Ste 250
Minneapolis, MN 55407-1355
Phone
(612) 863-4000
NPI assigned
Apr 2, 2020
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 70107 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2800 Chicago Ave Ste 250
Minneapolis, MN 55407-1355

Mailing address

2800 Chicago Ave Ste 250
Minneapolis, MN 55407-1355
Phone (612) 863-4000

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
I20230728002258 MN Practitioner - Internal Medicine 9335562008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 28, 2023 Accepting new patients
Allina Health System CurrentSince Aug 28, 2023 Accepting new patients
St Francis Regional Medical Center Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2800 Chicago Ave
Ste 250
Minneapolis, MN 55407
Phone (612) 863-4096

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1790314771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CHICAGO AVE STE 250",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071355",
            "telephone_number": "612-863-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CHICAGO AVE STE 250",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071355",
            "telephone_number": "612-863-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "70107",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.