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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | LP4310 | MN | Behavioral Health & Social Service Providers |
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 |
Street Address |
516 DELAWARE STREET SE PWB FOURTH FLOOR, ROOM 4-100 |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55455 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 55455 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
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] |
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 |
City | MINNEAPOLIS |
Zip Code | 55455 |
Please comment or provide details below to improve the information on MICHAEL J POTEGAL.
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.