NPIMap

Organization Active NPI

Millennium Neurosurgery, PA

  • Specialist
  • Maplewood, MN
National Provider Identifier
1851314868
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1473 Issued in MN
Legal business name
MILLENNIUM NEUROSURGERY, PA
Practice address
1675 Beam Ave
Suite 215
Maplewood, MN 55109-1172
Phone
(651) 748-1461
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Phudhiphorn Thienprasit, MDNPI 1437151669
Title
President
Phone
(651) 748-1461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 1473 MN Primary

Addresses

Primary practice location

1675 Beam Ave
Suite 215
Maplewood, MN 55109-1172

Mailing address

1675 Beam Ave
Suite 215
Maplewood, MN 55109-1172
Phone (651) 748-1461

Other identifiers 1

IdentifierTypeStateIssuer
CN3928OtherMNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1675 Beam Ave
Ste 215
Maplewood, MN 55109
Phone (651) 748-1461

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1851314868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BEAM AVE",
            "address_2": "SUITE 215",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091172",
            "telephone_number": "651-748-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BEAM AVE",
            "address_2": "SUITE 215",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091172",
            "telephone_number": "651-748-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM NEUROSURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "THIENPRASIT",
        "authorized_official_first_name": "PHUDHIPHORN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-748-1461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "1473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN3928",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.