Individual provider Active NPI

Craig A Solem

  • Gastroenterology Physician
  • Eagan, MN
National Provider Identifier
1801873377
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
42756 Issued in MN
Practice address
1185 Town Centre Dr Ste 205
Eagan, MN 55123-1370
Phone
(612) 871-1145
Fax
(612) 870-5491
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 42756 MN Primary

Addresses

Primary practice location

1185 Town Centre Dr Ste 205
Eagan, MN 55123-1370

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000089 MN Practitioner - Gastroenterology 4789625104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42756MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mngi Digestive Health, P.a. Gastroenterology CurrentSince Dec 1, 2015 Accepting new patients

Locations

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1801873377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR STE 205",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231370",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLEM",
        "first_name": "CRAIG",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "42756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.