Active NPI
Isaac Milton Engholm, D.O.
- Family Medicine Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 65161
- Practice address
- 825 Nicollet Mall Ste 403
Minneapolis, MN 55402-2611 - Phone
- (612) 712-4423
- Fax
- (763) 284-0254
- NPI assigned
- Jul 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 65161 | MN | Primary |
Addresses
Primary practice location
825 Nicollet Mall Ste 403
Minneapolis, MN 55402-2611
Mailing address
825 Nicollet Mall Ste 403
Minneapolis, MN 55402-2611
Phone (612) 712-4423
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | iengholm410647@excellian.direct.allina.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6341 University Ave NE
Fridley, MN 55432-4946
Phone (763) 572-5700
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients | |
| Fairview Clinics | Past | Accepting new patients |
Locations
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
1151 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (612) 706-4500
Interoperability endpoints
- iengholm410647@excellian.direct.allina.com
Organizations & group practices 11
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.
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Multi-Specialty Clinic/Center
- Fridley, MN
- NPI 1205017670
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- General Practice Physician
- Saint Paul, MN
- NPI 1346722675
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- Multi-Specialty Clinic/Center
- Maple Grove, MN
- NPI 1841315165
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1316008212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1881940864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 NICOLLET MALL STE 403",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022611",
"telephone_number": "612-712-4423",
"fax_number": "763-284-0254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 NICOLLET MALL STE 403",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022611",
"telephone_number": "612-712-4423",
"fax_number": "763-284-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGHOLM",
"first_name": "ISAAC",
"middle_name": "MILTON",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-27",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "65161",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "iengholm410647@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "825 Nicollet Mall Ste 403",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554022611",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.