NPIMap

Individual provider Active NPI

John David Schaffhausen, MD

  • Family Medicine Physician
  • Maple Grove, MN
National Provider Identifier
1912936428
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43035 Issued in MN
Practice address
9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768
Phone
(763) 587-7900
Fax
(763) 494-7501
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43035 MN Primary

Addresses

Primary practice location

9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768

Mailing address

9201 W Broadway Ave Ste 601
Brooklyn Park, MN 55445-1924
Phone (763) 587-7900

Other identifiers 1

IdentifierTypeStateIssuer
265428800MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.schaffhausen@nor.eclinicaldirectplus.com

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
I20100825000514 MN Practitioner - Family Practice 5496879637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Clinic PAGroup PAC ID 2769384205, 50 clinicians

Practice addresses (Care Compare)

9825 Hospital Dr
Suite 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Clinic, PA Family Medicine CurrentSince Sep 1, 2000 Accepting new patients
North Clinic, PA Family Medicine CurrentSince Sep 1, 2000 Accepting new patients

Locations

9825 Hospital Dr
Ste 300
Maple Grove, MN 55369
Phone (763) 494-7500

9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

Interoperability endpoints

  • Direct secure messaging: john.schaffhausen@nor.eclinicaldirectplus.com

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 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1912936428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W BROADWAY AVE STE 601",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451924",
            "telephone_number": "763-587-7900",
            "fax_number": "763-587-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 300",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694768",
            "telephone_number": "763-587-7900",
            "fax_number": "763-494-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFHAUSEN",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "43035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265428800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.schaffhausen@nor.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "9825 Hospital Dr",
            "address_2": "Suite 300",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553694479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.