NPIMap

Individual provider Active NPI

Theresa S. Covert, M.D.

  • Obstetrics & Gynecology Physician
  • Maple Grove, MN
National Provider Identifier
1972581148
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
46745 Issued in MN
Practice address
9855 Hospital Dr Ste 275
Maple Grove, MN 55369-4778
Phone
(952) 993-3282
Fax
(952) 993-1425
NPI assigned
Jan 6, 2006
Last updated
Feb 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 46745 MN Primary

Addresses

Primary practice location

9855 Hospital Dr Ste 275
Maple Grove, MN 55369-4778

Mailing address

8170 33Rd Ave S
PO Box 1309 Mail Stop 21110Q
Minneapolis, MN 55425-4516
Phone (952) 993-1440

Other identifiers 1

IdentifierTypeStateIssuer
896428900MedicaidMN

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
I20040816001436 MN Practitioner - Obstetrics/Gynecology 6901879105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Dakota School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Obstetrics & Gynecology CurrentSince Aug 22, 2007 Accepting new patients
Park Nicollet Clinic Obstetrics & Gynecology Current Accepting new patients
Park Nicollet Clinic CurrentSince Aug 22, 2007 Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients

Locations

9855 Hospital Dr
Ste 275
Maple Grove, MN 55369
Phone (763) 981-3200

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

4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000

Interoperability endpoints

  • Direct secure messaging: tcovert156894@direct.healthpartners.com

Organizations & group practices 4

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 6

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1972581148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "PO BOX 1309 MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-993-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 HOSPITAL DR STE 275",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694778",
            "telephone_number": "952-993-3282",
            "fax_number": "952-993-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERT",
        "first_name": "THERESA",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "46745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896428900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.