NPIMap

Individual provider Active NPI

Anthony Michaelis

  • Emergency Medicine Physician
  • Bloomington, MN
National Provider Identifier
1992244396
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
67399 Issued in MN
Practice address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone
(952) 835-9880
Fax
(952) 857-1554
NPI assigned
Feb 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101022980 MI
Emergency Medicine Physician 207P00000X 5151010487 MI
Emergency Medicine Physician 207P00000X 67399 MN Primary

Addresses

Primary practice location

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Other practice location 1

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 287-9029

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
I20200914000698 MN Practitioner - Emergency Medicine 6002186905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Professional AssociationGroup PAC ID 9537072657, 273 clinicians

Practice addresses (Care Compare)

4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362
  • Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151010487MIMDEmergency Medicine Physician
67399MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association CurrentSince Sep 14, 2020 Accepting new patients
Emergency Physicians Professional Association Emergency Medicine CurrentSince Sep 14, 2020 Accepting new patients

Locations

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: amichaelis535802@direct.centracare.com

Organizations & group practices 2

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 10

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1992244396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "734-287-9029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELIS",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022980",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151010487",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "67399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.