Minor Medical Squad PLLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

MINOR MEDICAL SQUAD PLLC

Practice address

5775 Wayzata Blvd Ste 700
St Louis Park, MN 55416-1233

Phone

(612) 504-6160

Fax

(855) 818-2050

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Michael Vito Dimucci, FNP-C

Title

Owner, Family Nurse Practitioner

Phone

(612) 805-8676

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20716/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821646985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 TRENTON LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414496",
            "telephone_number": "612-805-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 700",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161233",
            "telephone_number": "612-504-6160",
            "fax_number": "855-818-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOR MEDICAL SQUAD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2025-09-11",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "DIMUCCI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "VITO",
        "authorized_official_title_or_position": "OWNER, FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "612-805-8676",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Clinic/Center in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Community Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.