Individual provider Active NPI

Michael D Bateman, DO

  • Pediatrics Physician
  • Willmar, MN
National Provider Identifier
1851367924
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36464 Issued in MN
Practice address
101 Willmar Ave SW
Willmar, MN 56201
Phone
(320) 231-5000
Fax
(320) 231-5067
NPI assigned
Feb 27, 2006
Last updated
Sep 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36464 MN Primary

Addresses

Primary practice location

101 Willmar Ave SW
Willmar, MN 56201

Mailing address

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5000

Other identifiers 1

IdentifierTypeStateIssuer
397225900MedicaidMN

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
I20070920000156 MN Practitioner - Pediatric Medicine 0840209920 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36464MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Bethesda Hospital CurrentSince Mar 24, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 15, 2022 Accepting new patients
Healtheast Care System CurrentSince Mar 24, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 15, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

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

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: mbateman300937@fairview.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1851367924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "36464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "397225900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.