Individual provider Active NPI

Mark Brian Olmscheid Comnick, MD

  • Internal Medicine Physician
  • Wyoming, MN
National Provider Identifier
1851380752
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44941 Issued in MN
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7000
NPI assigned
Oct 14, 2005
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44941 MN Primary

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

Other identifiers 12

IdentifierTypeStateIssuer
1041077OtherPREFERRED ONE
143209OtherUCARE
882927600OtherMEDICAL ASSISTANCE
882927600MedicaidMN
EFF52704OtherMMSI
81604OtherFIRST HEALTH PLAN
HP42375OtherHEALTH PARTNERS
0406676OtherMEDICA HEALTH PLANS
2121656OtherARAZ GROUP AMERICAS PPO
842S4COOtherBLUE CROSS BLUE SHIELD
81604OtherCHAMPUS
92204OtherONE HEALTH PLAN GREAT WES

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
I20040624000326 MN Practitioner - NephrologyPractitioner - HospitalistPractitioner - Internal Medicine 9335124114 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist, Internal Medicine
Education
University of Washington School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
County of Meeker CurrentSince Apr 15, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Aug 18, 2017 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Apr 17, 2020 Accepting new patients
Welia Health Current Accepting new patients
County of Meeker CurrentSince Apr 15, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 17, 2020 Accepting new patients
Fairview Health Services CurrentSince Aug 18, 2017 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Welia Health CurrentSince Jul 1, 2022 Accepting new patients
Welia Health CurrentSince Jul 1, 2022 Accepting new patients
Mayo Clinic Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317

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

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

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

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: mcomnick191188@fairview.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1851380752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMNICK",
        "first_name": "MARK",
        "middle_name": "BRIAN OLMSCHEID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "44941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1041077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "143209",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "882927600",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "882927600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMSI",
            "identifier": "EFF52704",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "81604",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP42375",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "0406676",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP AMERICAS PPO",
            "identifier": "2121656",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "842S4CO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "81604",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN GREAT WES",
            "identifier": "92204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.