Individual provider Active NPI

Johannes Christiaan Coetzee, MB, CHB, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Edina, MN
National Provider Identifier
1891729000
Registry record updated Oct 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
41848 Issued in MN
Practice address
4010 W 65TH St
Edina, MN 55435-1706
Phone
(952) 456-7000
Fax
(952) 456-7001
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 41848 MN Primary

Addresses

Primary practice location

4010 W 65TH St
Edina, MN 55435-1706

Mailing address

4200 Dahlberg Dr
Suite 300
Golden Valley, MN 55422-4840
Phone (952) 512-5600

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
I20050830000842 MN Practitioner - Orthopedic Surgery 2961433818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Dec 1, 2005 Accepting new patients
Infinite Health Collaborative, PA Foot and Ankle Surgery CurrentSince Dec 1, 2005 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

6545 France Ave S
Ste 160
Minneapolis, MN 55435
Phone (952) 835-0750

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381104000000",
    "number": "1891729000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W 65TH ST",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351706",
            "telephone_number": "952-456-7000",
            "fax_number": "952-456-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COETZEE",
        "first_name": "JOHANNES",
        "middle_name": "CHRISTIAAN",
        "name_prefix": "Dr.",
        "credential": "MB, CHB, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MN",
            "license": "41848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.