NPIMap

Individual provider Active NPI

Robert Allan Nadeau, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Minneapolis, MN
National Provider Identifier
1881620771
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
S88 Issued in MN
Practice address
515 Delaware St. SE
7-174D Malcolm Moos Tower
Minneapolis, MN 55455
Phone
(612) 301-2233
NPI assigned
Jun 23, 2006
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2006015187 MO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X S88 MN Primary

Addresses

Primary practice location

515 Delaware St. SE
7-174D Malcolm Moos Tower
Minneapolis, MN 55455

Mailing address

730 N 4TH St Unit 402
Minneapolis, MN 55401-1985
Phone (816) 769-1661

Other practice location 1

2301 Holmes St
DT&C Bldg
Kansas City, MO 64108-2640
Phone (816) 404-0505

Other practice location 2

3405 Promenade Ave Ste 300
Eagan, MN 55123-4420
Phone (651) 236-7458

Other practice location 3

5220 Central Ave NE Ste 240
Columbia Heights, MN 55421-1823
Phone (763) 275-1319

Other practice location 4

1384 109th Ave NE Ste 200
Blaine, MN 55434-4543
Phone (763) 757-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020001974 MN Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3971769035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Minnesota School of Dentistry, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 Delaware St SE
7 220 Moos Tower
Minneapolis, MN 55455-0357

515 Delaware St SE
7 530 Moos Health Sciences Tower
Minneapolis, MN 55455-0329

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota Oral and Maxillofacial Surgery CurrentSince Sep 19, 2015 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Regents of the University of Minnesota CurrentSince Sep 19, 2015 Accepting new patients
University of Minnesota Physicians CurrentSince Sep 19, 2015 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Sep 19, 2015 Accepting new patients
Fairview Health Services Past Accepting new patients
Eagan Smiles Dentistry, PC Past Accepting new patients
Blaine Dentistry, PC Past Accepting new patients
Columbia Heights Dentistry, PC Past Accepting new patients

Locations

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

701 25th Ave S
Ste 400
Minneapolis, MN 55454
Phone (612) 626-7232

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

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1881620771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N 4TH ST UNIT 402",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011985",
            "telephone_number": "816-769-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST. SE",
            "address_2": "7-174D MALCOLM MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-301-2233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_2": "DT&C Bldg",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-0505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3405 Promenade Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551234420",
            "country_code": "US",
            "telephone_number": "651-236-7458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5220 Central Ave NE Ste 240",
            "address_purpose": "LOCATION",
            "city": "Columbia Heights",
            "state": "MN",
            "postal_code": "554211823",
            "country_code": "US",
            "telephone_number": "763-275-1319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1384 109th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554344543",
            "country_code": "US",
            "telephone_number": "763-757-6000",
            "fax_number": "763-757-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "ROBERT",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2006015187",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "S88",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.