Active NPI
James S Mallery, MD
- Gastroenterology Physician
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 36617
- Practice address
- 6500 Excelsior Blvd Suite 4-820
Digestive and Endoscopy Center Methodist Hospital
St Louis Park, MN 55426 - Phone
- (952) 993-3240
- Fax
- (952) 993-2640
- NPI assigned
- Jun 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 36617 | MN | Primary |
Addresses
Primary practice location
6500 Excelsior Blvd Suite 4-820
Digestive and Endoscopy Center Methodist Hospital
St Louis Park, MN 55426
Mailing address
6500 Excelsior Blvd Suite 4-820
Digestive and Endoscopy Center Methodist Hospital
St Louis Park, MN 55426
Phone (952) 993-3240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 834323300 | Medicaid | MN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000
717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422
Hospital & facility affiliations
- M Health Fairview University of MN Medical Center
- M Health Fairview Woodwinds Hospital
- M Health Fairview Southdale Hospital
- Fairview Lakes Health Services
- M Health Fairview St John'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.63 of 100
- Quality
- 75.41
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 28 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 117 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36617 | MN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Healtheast Care System | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center Inc | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Healtheast Woodwinds Hospital | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| Healtheast St. John'S Hospital | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center, Inc. | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Methodist Hospital | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Fairview Bethesda Hospital | Current | Accepting new patients |
Locations
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000
559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
6500 Excelsior Blvd
Ste 4820
St Louis Park, MN 55426
Phone (952) 993-3123
1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100
Interoperability endpoints
- jmallery148206@fairview.direct-ci.com
Organizations & group practices 21
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Long Term Care Hospital
- Saint Paul, MN
- NPI 1194787465
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- General Acute Care Hospital
- Maplewood, MN
- NPI 1447218482
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1356309322
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Clinic/Center
- Minneapolis, MN
- NPI 1053795187
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1447442132
-
- Primary Care Clinic/Center
- Wyoming, MN
- NPI 1659525848
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1316008212
-
- General Acute Care Hospital
- Edina, MN
- NPI 1699752915
-
- General Acute Care Hospital
- Edina, MN
- NPI 1932260833
-
- General Acute Care Hospital
- Maplewood, MN
- NPI 1447218482
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1356309322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1851331441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD SUITE 4-820",
"address_2": "DIGESTIVE AND ENDOSCOPY CENTER METHODIST HOSPITAL",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55426",
"telephone_number": "952-993-3240",
"fax_number": "952-993-2640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD SUITE 4-820",
"address_2": "DIGESTIVE AND ENDOSCOPY CENTER METHODIST HOSPITAL",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55426",
"telephone_number": "952-993-3240",
"fax_number": "952-993-2640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLERY",
"first_name": "JAMES",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "36617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "834323300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.