Individual provider Active NPI

Guy P Runkle, MD

  • Family Medicine Physician
  • St Paul, MN
National Provider Identifier
1922071489
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G062785 Issued in CA
Practice address
1026 W 7TH Street
St Paul, MN 55102-3007
Phone
(651) 241-1000
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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 G062785 CA Primary

Addresses

Primary practice location

1026 W 7TH Street
St Paul, MN 55102-3007

Mailing address

1026 W 7TH Street
St Paul, MN 55102-3007
Phone (651) 241-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070714000011 MN Practitioner - Family Practice 8224133509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

4695 Shoreline Dr
Spring Park, MN 55384-9715
Phone (952) 442-7890

Hospital & facility affiliations

  • Ridgeview Home Care Services Home health agency, Waconia, MN, CCN 247168
  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G062785CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients

Locations

500 S Maple St
Ofc
Waconia, MN 55387

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1922071489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNKLE",
        "first_name": "GUY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G062785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

Verify at the official NPI Registry.