Active NPI
Mark S Paller, MD
- Nephrology Physician
- Minneapolis, MN
National Provider Identifier
1841304359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 27179
- Practice address
- 516 Delaware Street SE, PWB, Clinic 2a
University of Minnesota Physicians
Minneapolis, MN 55455 - Phone
- (612) 626-6100
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27179 | MN | |
| Nephrology Physician | 207RN0300X | 27179 | MN | Primary |
Addresses
Primary practice location
516 Delaware Street SE, PWB, Clinic 2a
University of Minnesota Physicians
Minneapolis, MN 55455
Mailing address
420 Delaware St SE,
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 626-6100
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2T173PA | Other | MN | BLUECROSS BLUESHIELD |
| 30713400 | Medicaid | WI | |
| 168568600 | Medicaid | MN | |
| 31-00005 | Other | MEDICA - PRIMARY | |
| 0051986 | Medicaid | MT | |
| 768290 | Other | ARAZ | |
| 0500553 | Medicaid | IA | |
| 1009263 | Other | PREFERREDONE | |
| 101500 | Other | UCARE | |
| HP22172 | Other | HEALTHPARTNERS | |
| 31-24565 | Other | MEDICA - CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1841304359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE,",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE STREET SE, PWB, CLINIC 2A",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLER",
"first_name": "MARK",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "27179",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MN",
"license": "27179",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "2T173PA",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30713400",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168568600",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA - PRIMARY",
"identifier": "31-00005",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0051986",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "768290",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0500553",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1009263",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "101500",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP22172",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA - CHOICE",
"identifier": "31-24565",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.