NPIMap

Individual provider Active NPI

Evidio Domingo Musibay, MD

  • Medical Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1831321785
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
52977 Issued in MN
Practice address
800 E 28TH St Ste 401
Minneapolis, MN 55407-3723
Phone
(612) 863-0200
Fax
(612) 863-0235
NPI assigned
Aug 11, 2009
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 52977 MN
Medical Oncology Physician 207RX0202X 52977 MN Primary

Addresses

Primary practice location

800 E 28TH St Ste 401
Minneapolis, MN 55407-3723

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other identifiers 3

IdentifierTypeStateIssuer
P01075996OtherMNRAIL ROAD - MEDICARE
ENROLLEDMedicaidMN
ENROLLEDMedicaidIA

Other names 1

  • Evidio Domingo Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edomingomusibay652424@excellian.direct.allina.com Direct

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
I20101216000744 MN Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Hematology 9234327313 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

800 E 28TH St
Suite 401
Minneapolis, MN 55407-3723
Phone (612) 863-0200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Feb 26, 2024 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2016 Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Allina Health System CurrentSince Feb 26, 2024 Accepting new patients
NPI 1083910871 Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

11850 Blackfoot St NW
Ste 300
Minneapolis, MN 55433
Phone (763) 236-0808

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

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

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

420 Delaware St SE
#480
Minneapolis, MN 55455
Phone (612) 624-0123

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

800 E 28th St
Ste 401
Minneapolis, MN 55407
Phone (612) 863-0200

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

Interoperability endpoints

  • Direct secure messaging: edomingomusibay652424@excellian.direct.allina.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1831321785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE 401",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-0200",
            "fax_number": "612-863-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO MUSIBAY",
        "first_name": "EVIDIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MN",
            "license": "52977",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "52977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD - MEDICARE",
            "identifier": "P01075996",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edomingomusibay652424@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St Ste 401",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EVIDIO",
            "last_name": "DOMINGO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.