Active NPI
Andrew D Maas, MD
- Family Medicine Physician
- Eagan, MN
National Provider Identifier
1972527422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 39139
- Practice address
- 4540 Oak Pond Rd
Eagan, MN 55123-1990 - Phone
- (651) 328-3047
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39139 | MN | Primary |
Addresses
Primary practice location
4540 Oak Pond Rd
Eagan, MN 55123-1990
Mailing address
4540 Oak Pond Rd
Eagan, MN 55123-1990
Phone (651) 328-3047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 899970800 | Medicaid | MN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39139 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1972527422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4540 OAK POND RD",
"city": "EAGAN",
"state": "MN",
"postal_code": "551231990",
"telephone_number": "651-328-3047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4540 OAK POND RD",
"city": "EAGAN",
"state": "MN",
"postal_code": "551231990",
"telephone_number": "651-328-3047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAAS",
"first_name": "ANDREW",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "39139",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "899970800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.