Individual provider Active NPI

Alexander Ivaskovic, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Maplewood, MN
National Provider Identifier
1831391432
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
50007 Issued in MN
Practice address
1575 Beam Ave
Maplewood, MN 55109-1126
Phone
(651) 232-7132
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2009004340 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 50007 MN Primary

Addresses

Primary practice location

1575 Beam Ave
Maplewood, MN 55109-1126

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-1111

Other practice location 1

1102 W 32nd St
Joplin, MO 64804-3503
Phone (417) 347-1111

Other identifiers 4

IdentifierTypeStateIssuer
ENROLLEDMedicaidIA
ENROLLEDMedicaidMN
35222300MedicaidWI
547478000MedicaidMN

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
I20070711000494 MN Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1153421706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

1700 University Ave W
Saint Paul, MN 55104-3727

45 10TH St W
Saint Paul, MN 55102-1062
Phone (651) 232-3000

Hospital & facility affiliations

  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50007MNMDCritical Care Medicine (Internal Medicine) Physician
103103MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Insititue CurrentSince Oct 31, 2013 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 31, 2013 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jun 11, 2021 Accepting new patients
Fairview Health Services CurrentSince Feb 2, 2019 Accepting new patients
Fairview Health Services CurrentSince Feb 2, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jun 11, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients

Locations

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

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

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

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

Interoperability endpoints

  • Direct secure messaging: aivaskovic470136@fairview.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1831391432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091126",
            "telephone_number": "651-232-7132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 W 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043503",
            "country_code": "US",
            "telephone_number": "417-347-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVASKOVIC",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2009004340",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "50007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35222300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547478000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.