NPIMap

Individual provider Active NPI

Micaela T Chatman, MD

  • Neurology Physician
  • Roseville, MN
National Provider Identifier
1902067002
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
55242 Issued in MN
Practice address
2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306
Phone
(651) 241-5290
Fax
(651) 241-5248
NPI assigned
Jun 20, 2008
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 55242 MN Primary

Addresses

Primary practice location

2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306

Mailing address

2720 Fairview Ave N Ste 100
Roseville, MN 55113-1306
Phone (651) 241-5290

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
I20121004000414 MN Practitioner - Neurology 9335398494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Virginia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Epilepsy Group PAGroup PAC ID 6709771363, 24 clinicians

Practice addresses (Care Compare)

2720 Fairview Ave N
Suite 100
Roseville, MN 55113-1306
Phone (651) 241-5290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55242MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Epilepsy Group PA Neurology CurrentSince Sep 1, 2013 Accepting new patients
Allina Health System Past Accepting new patients

Locations

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

225 Smith Ave N
Ste 201
Saint Paul, MN 55102
Phone (651) 241-5290

2720 Fairview Ave N
#100
Saint Paul, MN 55113
Phone (651) 241-5290

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFDABA

Organizations & group practices 2

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 47

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1902067002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATMAN",
        "first_name": "MICAELA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "55242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.