Mark D Seaburg

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30636 Issued in MN

Practice address

2001 Blaisdell Ave
Minneapolis, MN 55404-2414

Phone

(952) 993-8000

Fax

(952) 993-8039

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Wisconsin School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mseaburg21646@direct.healthpartners.com

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1790762391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "CREDENTIALING",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLAISDELL AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042414",
            "telephone_number": "952-993-8000",
            "fax_number": "952-993-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEABURG",
        "first_name": "MARK",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "30636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Frances Scullin, OTR
• Diane Marie Scuto
• SE Homes Recovery Inc
• David J Seabolt, NP
• Jon Konrad Seaburg, LADC , LPCC
• Emma L Seamans
• Matthew A Seamon, MA LAT ATC
• Elizabeth Rachel Seaquist, MD
• Jan Search, MSW, LICSW
• Bethany Christenson Searl, LICSW

• Internal Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.

Verify at the official NPI Registry.