Individual provider Active NPI

Thomas P Noonan, M.D.

  • Obstetrics & Gynecology Physician
  • Edina, MN
National Provider Identifier
1861409666
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27176 Issued in MN
Practice address
3625 W 65TH St
Suite 100
Edina, MN 55435-2106
Phone
(952) 920-7001
Fax
(952) 920-2245
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 27176 MN Primary

Addresses

Primary practice location

3625 W 65TH St
Suite 100
Edina, MN 55435-2106

Mailing address

3625 W 65TH St
Suite 100
Edina, MN 55435-2106
Phone (952) 920-7001

Other identifiers 2

IdentifierTypeStateIssuer
0703692OtherMNMEDICA
174K9NOOtherMNBCBS

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
I20040105000386 MN Practitioner - Obstetrics/Gynecology 1052210598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27176MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Mar 3, 2008 Accepting new patients
Fairview Clinics CurrentSince Mar 3, 2008 Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

305 E Nicollet Blvd
Ste 372
Burnsville, MN 55337
Phone (952) 460-4130

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

18580 Joplin Ave
Lakeville, MN 55044
Phone (952) 892-9500

4151 Willowwood St SE
Prior Lake, MN 55372
Phone (952) 226-2600

Interoperability endpoints

  • Direct secure messaging: tnoonan3005@fairview.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861409666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 W 65TH ST",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352106",
            "telephone_number": "952-920-7001",
            "fax_number": "952-920-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 W 65TH ST",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352106",
            "telephone_number": "952-920-7001",
            "fax_number": "952-920-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "27176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0703692",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "174K9NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.