Individual provider Active NPI

Thomas Matthew Sutton, M.D.

  • Pediatric Cardiology Physician
  • Minneapolis, MN
National Provider Identifier
1922047604
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
24123 Issued in MN
Practice address
2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291
Phone
(612) 813-8800
Fax
(612) 813-8825
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 24123 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291

Mailing address

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291
Phone (612) 813-8800

Other identifiers 2

IdentifierTypeStateIssuer
30391000MedicaidWI
616387400MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1922047604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "THOMAS",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "24123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30391000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616387400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "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 Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.