NPIMap

Organization Active NPI

North Shore Anesthesia P.a

  • Anesthesiology Physician
  • Duluth, MN
National Provider Identifier
1922051291
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTH SHORE ANESTHESIA P.A
Practice address
1420 London Rd
Suite 100
Duluth, MN 55805-2433
Phone
(218) 728-0650
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Authorized official

Name
Hal B Heyer, MDNPI 1487608675
Title
President
Phone
(218) 728-8548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1420 London Rd
Suite 100
Duluth, MN 55805-2433

Mailing address

14700 28TH Ave N
Suite 20
Plymouth, MN 55447-4835
Phone (763) 559-3779

Other identifiers 1

IdentifierTypeStateIssuer
028704100MedicaidMN

Other names 1

  • North Shore Anesthesia Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000114 MN Part B Supplier - Clinic/Group Practice 9032016936 Receives reassigned benefits from 50 practitioners
Practice locations: Duluth, MN; Virginia, MN

National Provider Directory

National Provider Directory

Locations

4316 Rice Lake Rd
Ste 104
Duluth, MN 55811
Phone (218) 514-0514

2118 London Rd
Duluth, MN 55812
Phone (218) 481-7812

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1922051291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N",
            "address_2": "SUITE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474835",
            "telephone_number": "763-559-3779",
            "fax_number": "763-450-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 100",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-728-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE ANESTHESIA P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "HEYER",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-728-8548",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028704100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Anesthesia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.