MICHAEL J POTEGAL


Address: 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455
Phone: 6126257466

MICHAEL J POTEGAL (NPI# 1588748818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588748818
Entity Type Individual
Full Name MICHAEL J POTEGAL
Credential PHD
Practice Address 516 Delaware Street Se
Pwb Fourth Floor, Room 4-100
Minneapolis
MN 55455
Mailing Address 420 Delaware Street Se
University of Minnesota Physicians
Minneapolis
MN 55455
Practice Telephone 6126257466
Mailing Telephone 6126257466
Enumeration Date 2006-10-24
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist LP4310 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
SD 7777470 05
MT 0492031 05
MN PREFERRED ONE 1029892 01
MN BLUE CROSS BLUE SHIELD 163A1PO 01
ND 10387 05
MN ARAZ 1497309 01
MN HEALTH PARTNERS HP40584 01
MN UCARE 140910 01

Office Location

Street Address 516 DELAWARE STREET SE
PWB FOURTH FLOOR, ROOM 4-100
City MINNEAPOLIS
State MN
Zip Code 55455

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932193083 Daniel James Guillaume Neurological Surgery 516 Delaware Street Se, Ump Neurosurgery Clinic, Minneapolis, MN 55455 2005-09-06
1194042689 Amy Ann Mrazek Surgery 516 Delaware Street Se, Pwb 11-145e, Mmc 195, Minneapolis, MN 55455 2010-04-23
1932340213 Daniel Joshua Steinberger Radiology 516 Delaware Street Se, Umphysicians Imaging Center, Minneapolis, MN 55455 2009-03-16
1518129071 Torfi Thorkell Hoskuldsson Surgery 516 Delaware Street Se, Ump Surgery Clinic, Minneapolis, MN 55455-0356 2008-06-26
1659407708 Deanna G.k. Teoh Obstetrics & Gynecology 516 Delaware Street Se, Women's Health Center, Minneapolis, MN 55455 2007-02-25
1295877702 Kelly Renee Dietz Radiology 516 Delaware Street Se, Umphysicians Imaging Center, Minneapolis, MN 55455-0341 2007-02-12
1417031279 Carrie Kissling Registered Nurse 516 Delaware Street Se, Pwb Third Floor, Clinic 3b, Minneapolis, MN 55455 2006-10-25
1295819498 Anna Petryk Pediatrics 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 2006-10-24
1972687366 Jonathan I Ravdin Internal Medicine 516 Delaware Street Se, Pwb Sixth Floor, Clinic 6b, Minneapolis, MN 55455 2006-10-24
1942382452 Mark Richard Schleiss Pediatrics 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 2006-10-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932715679 Kara Biscobing Nurse Anesthetist, Certified Registered M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 2020-09-18
1982213237 Yue Hu Dentist 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 2020-07-23
1952922148 Jacob Laurence Tigner Student in an Organized Health Care Education/Training Program 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 2020-04-29
1710507538 Rachael Grundman Student in an Organized Health Care Education/Training Program 420 Delaware St, Mmc 395, Minneapolis, MN 55455 2020-04-22
1497375240 Sanjay Dhawan Student in an Organized Health Care Education/Training Program 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 2020-04-22
1508486549 Dariel Andres Diaz Student in an Organized Health Care Education/Training Program 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 2020-04-20
1275186280 Kerem Ozturk Radiology B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 2019-07-18
1275194631 Andres Jose Gonzalez Coba Student in an Organized Health Care Education/Training Program 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 2019-06-26
1841850278 Brendan Andrew Schleyer Dentist 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 2019-06-18
1932767399 Claire-audrey Y Bayan Student in an Organized Health Care Education/Training Program 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 2019-05-31
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285118687 Chimei M Lee Clinical Neuropsychologist 717 Delaware St Se Ste 340, Minneapolis, MN 55414-2959 2018-09-20
1962750026 Paul Marshall LLC Clinical Neuropsychologist 825 Nicollet Mall Ste 1440, Medical Arts Bldg, Minneapolis, MN 55402-2718 2012-08-21
1780977934 Samantha Glass Clinical Neuropsychologist 701 Park Ave # G8, Minneapolis, MN 55415-1623 2011-05-20
1467660084 Robin Lee Wetzel Clinical Neuropsychologist 1625 Park Ave, Minneapolis, MN 55404-1634 2007-05-18
1912022336 Learning and Language Specialists, Inc. Clinical Neuropsychologist 1405 Lilac Dr N Ste 200, Minneapolis, MN 55422-4546 2007-03-21
1619050028 Robin Rumsey Clinical Neuropsychologist 717 Delaware St Se Ste 240, Minneapolis, MN 55414-2959 2006-10-23
1497837041 William Thomas O'dowd Clinical Neuropsychologist 2720 W 43rd St, Suite 205, Minneapolis, MN 55410-1643 2006-10-20
1568418812 Christopher James Boys Clinical Neuropsychologist 200 Oak St Se, 160 Mcnamara Mcnamara, University of Minnesota Physicians, Minneapolis, MN 55455 2006-05-26
1649819665 Amanda Wenzel Kalstabakken Clinical Neuropsychologist 2512 S 7th St, Minneapolis, MN 55454-1404 2019-12-23
1104476589 Leslie N Perez Clinical Neuropsychologist 701 Park Ave, Minneapolis, MN 55415-1623 2019-09-17
Find all providers in MINNEAPOLIS

Competitor

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City MINNEAPOLIS
Zip Code 55455

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Dataset Information

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.

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