NPIMap

Individual provider Active NPI

Christopher Milton Antolak, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1841209111
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48560 Issued in MN
Practice address
2600 39TH Ave NE
Minneapolis, MN 55421-4379
Phone
(612) 706-2900
Fax
(612) 706-2901
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48560 MN Primary

Addresses

Primary practice location

2600 39TH Ave NE
Minneapolis, MN 55421-4379

Mailing address

2600 39TH Ave NE
Minneapolis, MN 55421-4379
Phone (612) 706-2900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cantolak93162@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
I20060810000136 MN Practitioner - Family Practice 3678576774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48560MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Family Medicine CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince May 30, 2017 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince May 30, 2017 Accepting new patients
Allina Health System Family Medicine Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

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

10705 Town Square Dr NE
Ste 100
Minneapolis, MN 55449
Phone (763) 236-5400

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

4625 Churchill St
Shoreview, MN 55126
Phone (651) 483-3522

Interoperability endpoints

  • Direct secure messaging: cantolak93162@excellian.direct.allina.com

Organizations & group practices 5

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1841209111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 39TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554214379",
            "telephone_number": "612-706-2900",
            "fax_number": "612-706-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 39TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554214379",
            "telephone_number": "612-706-2900",
            "fax_number": "612-706-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOLAK",
        "first_name": "CHRISTOPHER",
        "middle_name": "MILTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "48560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cantolak93162@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "10705 Town Square Dr NE Ste 100",
            "city": "Blaine",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554498185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.