DR. BRUCE IRA IDELKOPE (NPI# 1083661680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083661680 |
| Entity Type | Individual |
| Full Name | DR. BRUCE IRA IDELKOPE |
| Credential | M.D. |
| Practice Address |
3400 W 66th St Suite 150 Edina MN 55435-2109 |
| Practice Telephone | 9529207200 |
| Practice Fax Number | 7633024234 |
| Mailing Telephone | 9529207200 |
| Mailing Fax Number | 7633024234 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2011-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
22536 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 30203900 | 05 | |
| MN | PREFERRED ONE | 0265008 | 01 |
| MN | RAILROAD MEDICARE | 130005771 | 01 |
| MN | BCBS OF MN | 07620ID | 01 |
| MN | UCARE | 100288C029 | 01 |
| MN | HEALTHPARTNERS | HP13585 | 01 |
| MN | AMERICA'S PPO | 25828 | 01 |
| MN | 489092200 | 05 | |
| MN | MEDICA | 0501641 | 01 |
| Street Address |
3400 W 66TH ST SUITE 150 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094392 | Lisa T Ley | Physician Assistant | 3400 W 66th St, Ste 385, Edina, MN 55435-2197 | 2005-06-21 |
| 1033689674 | Nicholas Roffers | Speech-Language Pathologist | 3400 W 66th St, Edina, MN 55435-2111 | 2018-11-27 |
| 1003351156 | Lindsay Kuphal | Nurse Practitioner | 3400 W 66th St, Edina, MN 55435-2111 | 2016-12-28 |
| 1326410580 | Jody Bishop | Hearing Instrument Specialist | 3400 W 66th St, Ste 140, Edina, MN 55435-2109 | 2015-10-28 |
| 1730555889 | Danielle Bandholz | Nurse Practitioner | 3400 W 66th St, Suite 290, Edina, MN 55435-2111 | 2015-08-12 |
| 1780067033 | Katherine Marie Breezley | Registered Nurse | 3400 W 66th St, Edina, MN 55435-2111 | 2015-07-06 |
| 1861885881 | Connect Hearing, Inc. | Audiologist | 3400 W 66th St, Ste 140, Edina, MN 55435-2111 | 2015-03-16 |
| 1124419825 | Lauren Christine Bloomgren | Hearing Instrument Specialist | 3400 W 66th St, Suite 140, Edina, MN 55435-2111 | 2015-02-17 |
| 1346657160 | Fairview Health Services | Family Medicine | 3400 W 66th St, Suite 290, Edina, MN 55435-2111 | 2014-07-14 |
| 1821437955 | Sarah Watkins Lee | Registered Nurse | 3400 W 66th St, 290, Edina, MN 55435-2111 | 2013-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700880754 | Steven F Noran | Psychiatry & Neurology | 7373 France Ave S, Ste 604, Edina, MN 55435-4552 | 2005-06-08 |
| 1356761639 | Jessica Jarnot | Psychiatry & Neurology | 6401 France Ave S, Edina, MN 55435-2104 | 2014-04-24 |
| 1033205083 | Sunhee Kim | Psychiatry & Neurology | 3400 W 66th St Ste 150, Edina, MN 55435-2109 | 2006-10-05 |
| 1588671259 | Joel I Gedan | Psychiatry & Neurology | 6545 France Ave S, Suite #670, Edina, MN 55435 | 2006-08-02 |
| 1992721658 | Alexander Y Zubkov | Psychiatry & Neurology | 3400 W 66th St, Ste 150, Edina, MN 55435-2109 | 2006-07-14 |
| 1689600595 | John Edwin Trusheim | Psychiatry & Neurology | 3400 W 66th St, Suite 150, Edina, MN 55435-2109 | 2006-06-23 |
| 1477598977 | Felix Zwiebel | Psychiatry & Neurology | 3400 W 66th St, Suite 150, Edina, MN 55435-2109 | 2006-06-18 |
| 1740225473 | Yelena Victorovna Usmanova | Psychiatry & Neurology | 3400 W 66th St, Suite 150, Edina, MN 55435-2109 | 2006-06-17 |
| 1396787297 | Steven David Stein | Psychiatry & Neurology | 3400 W 66th St, Suite 150, Edina, MN 55435-2109 | 2006-06-12 |
| 1194779389 | Janiece Marie Aldinger | Psychiatry & Neurology | 3400 W 66th St, Suite 150, Edina, MN 55435-2109 | 2006-05-20 |
| Find all providers in EDINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.