Individual provider Active NPI

Thomas Bruce Ferrara, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Maple Grove, MN
National Provider Identifier
1861430605
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
25982 Issued in MN
Practice address
9325 Upland LN N Ste 360
Maple Grove, MN 55369-4463
Phone
(612) 322-6903
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 25982 MN Primary

Addresses

Primary practice location

9325 Upland LN N Ste 360
Maple Grove, MN 55369-4463

Mailing address

9325 Upland Lane N
Suite 360
Maple Grove, MN 55369
Phone (612) 322-6903

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (612) 322-6903

Other practice location 2

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20150211000684 ND Practitioner - Pediatric Medicine 3870558018 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25982MNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Nov 22, 2014 Accepting new patients
St. Alexius Medical Center CurrentSince Nov 22, 2014 Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients
Minnesota Neonatal Physicians PA Neonatal-Perinatal Medicine PastSince Nov 29, 2004 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1861430605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LANE N",
            "address_2": "SUITE 360",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "612-322-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N STE 360",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694463",
            "telephone_number": "612-322-6903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "612-322-6903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRARA",
        "first_name": "THOMAS",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "25982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.