NPIMap

Individual provider Active NPI

Charles Haugen Horowitz, M.D.

  • Neurology Physician
  • Maple Grove, MN
National Provider Identifier
1992745525
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
30619 Issued in MN
Practice address
9825 Hospital Dr
Suite 103
Maple Grove, MN 55369-4769
Phone
(763) 302-4114
Fax
(763) 302-4081
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 30619 MN Primary

Addresses

Primary practice location

9825 Hospital Dr
Suite 103
Maple Grove, MN 55369-4769

Mailing address

9825 Hospital Dr
Suite 103
Maple Grove, MN 55369-4769
Phone (763) 302-4114

Other identifiers 10

IdentifierTypeStateIssuer
0265034OtherMNPREFERRED ONE
22786OtherMNAMERICA'S PPO
394788200MedicaidMN
0515203OtherMNMEDICA
14618HOOtherMNBCBS OF MN
100284C029OtherMNUCARE
1964130MedicaidIA
31452100MedicaidWI
HP13549OtherMNHEALTHPARTNERS
130004185OtherMNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Minnesota Medical School, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30619MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care Current Accepting new patients

Locations

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

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1992745525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR",
            "address_2": "SUITE 103",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694769",
            "telephone_number": "763-302-4114",
            "fax_number": "763-302-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR",
            "address_2": "SUITE 103",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694769",
            "telephone_number": "763-302-4114",
            "fax_number": "763-302-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOROWITZ",
        "first_name": "CHARLES",
        "middle_name": "HAUGEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "30619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "0265034",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "22786",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "394788200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0515203",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "14618HO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "100284C029",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1964130",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31452100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP13549",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130004185",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.