NPIMap

Individual provider Active NPI

Russell Spingarn, M.D.

  • Family Medicine Physician
  • White Bear Lake, MN
National Provider Identifier
1922441278
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58462 Issued in MN
Practice address
1430 Highway 96 E
White Bear Lake, MN 55110-3653
Phone
(651) 653-2100
Fax
(651) 653-2125
NPI assigned
Apr 16, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 65824-20 WI
Family Medicine Physician 207Q00000X 58462 MN Primary

Addresses

Primary practice location

1430 Highway 96 E
White Bear Lake, MN 55110-3653

Mailing address

PO Box 1309
Ms 21110Q
Minneapolis, MN 55440-1309
Phone (651) 653-2100

Other practice location 1

1687 E Division St
River Falls, WI 54022-1571
Phone (715) 425-6701

Other practice location 2

1687 E Division St
River Falls, WI 54022-1571
Phone (715) 425-6701

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
I20141020001739 MN Practitioner - Family Practice 7416178298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1430 Hwy 96 E
White Bear Lake, MN 55110-3653
Phone (651) 426-9502

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

State licenses

LicenseStateTypeSpecialty
58462MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Apr 14, 2020 Accepting new patients
Group Health, Inc. Family Medicine CurrentSince Feb 5, 2018 Accepting new patients
Group Health, Inc. Current Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Group Health, Inc. CurrentSince Feb 5, 2018 Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

295 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

1430 Highway 96 E
White Bear Lake, MN 55110
Phone (651) 426-9502

Interoperability endpoints

  • Direct secure messaging: rspingarn220308@direct.healthpartners.com

Organizations & group practices 6

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 8

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922441278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "651-653-2100",
            "fax_number": "651-653-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HIGHWAY 96 E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103653",
            "telephone_number": "651-653-2100",
            "fax_number": "651-653-2125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1687 E Division St",
            "address_purpose": "LOCATION",
            "city": "River Falls",
            "state": "WI",
            "postal_code": "540221571",
            "country_code": "US",
            "telephone_number": "715-425-6701",
            "fax_number": "715-426-3994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1687 E Division St",
            "address_purpose": "LOCATION",
            "city": "River Falls",
            "state": "WI",
            "postal_code": "540221571",
            "country_code": "US",
            "telephone_number": "715-425-6701",
            "fax_number": "715-426-3994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPINGARN",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65824-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.