MODEN MEDICAL GROUP PLLC (NPI# 1598174666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598174666 |
| Entity Type | Organization |
| Organization Name | MODEN MEDICAL GROUP PLLC |
| Practice Address |
901 9th St N Virginia MN 55792-2325 |
| Mailing Address |
100 S 5th St Ste 1900 Minneapolis MN 55402-1267 |
| Practice Telephone | 6122368911 |
| Practice Fax Number | 6123927965 |
| Mailing Telephone | 8888221184 |
| Mailing Fax Number | 6123927965 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | DR. HOJUNG JOSEPH YOON (PRESIDENT/CEO) |
| Authorized Official Telephone | 8888221184 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 42296 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
901 9TH ST N |
| City | VIRGINIA |
| State | MN |
| Zip Code | 55792-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617120 | Essentia Health Virginia, LLC | General Acute Care Hospital | 901 9th St N, Virginia, MN 55792-2325 | 2005-05-23 |
| 1174184717 | Zachary B Horoshak | Physician Assistant | 901 9th St N, Virginia, MN 55792-2325 | 2019-06-25 |
| 1629543368 | Rachel Anne Eisenhuth | Physical Therapist | 901 9th St N, Virginia, MN 55792-2325 | 2018-10-09 |
| 1194214858 | Haley Therese Mckee | Speech-Language Pathologist | 901 9th St N, Virginia, MN 55792-2325 | 2018-05-08 |
| 1518478346 | Melissa M. Devries | Nurse Practitioner | 901 9th St N, Virginia, MN 55792-2325 | 2017-10-19 |
| 1417474461 | Katy Decker | Physical Therapist | 901 9th St N, Virginia, MN 55792-2325 | 2017-08-29 |
| 1548613144 | Molly Ongaro | Dietitian, Registered | 901 9th St N, Virginia, MN 55792-2325 | 2016-07-19 |
| 1508244864 | Tally Puffer | Speech-Language Pathologist | 901 9th St N, Virginia, MN 55792-2325 | 2015-05-07 |
| 1679968010 | David Martin Fedor | Surgery | 901 9th St N, Virginia, MN 55792-2325 | 2015-04-02 |
| 1114315652 | Sara Luoma | Nurse Practitioner | 901 9th St N, Essentia Health Virginia Medical Arts Clinic, Virginia, MN 55792-2325 | 2015-01-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252983 | Teresa A Larrabee | Social Worker | 624 South 13th Street, Virginia, MN 55792 | 2018-04-20 |
| 1972874105 | Caryn M. Walters | Counselor | 504 1st St. S., Virginia, MN 55792 | 2012-01-19 |
| 1144502923 | Crystal Corrine Leal | Student in an Organized Health Care Education/Training Program | 624 S. 13th St., Virginia, MN 55792 | 2011-09-16 |
| 1417259110 | Ellen C. Taube | Pharmacist | 306 Chestnut, Virginia, MN 55792 | 2010-12-01 |
| 1518295567 | Virginia-gilbert Family Dental P.a | Dentist | 612-13th. St. So., Virginia, MN 55792 | 2009-12-03 |
| 1942442082 | Arrowhead Economic Opportunity Agency | In Home Supportive Care | 702 South Third Avenue, Virginia, MN 55792 | 2009-04-06 |
| 1609037324 | Stefan Leroy Kaiser | Preventive Medicine | 1101 9th St. N, Essentia Health Virginia Clinic, Virginia, MN 55792 | 2008-06-25 |
| 1457512915 | Duane Faccin Person | Legal Medicine | 910 6th St N, Duluth Clinic Virginia, Virginia, MN 55792 | 2008-06-18 |
| 1932368313 | Range Mental Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 731 3rd St S, Virginia, MN 55792 | 2008-06-02 |
| 1871634071 | Gary Frederick Miller | Social Worker | 624 S 13th Street, P O 1188, Virginia, MN 55792 | 2007-02-09 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134295264 | Winston Stephen Schandorf | Internal Medicine | 901 Ninth Street North, Virginia, MN 55792-2398 | 2006-11-28 |
| 1497765325 | Kassamali Jamal | Internal Medicine | 604 9th St N, Virginia, MN 55792-2320 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295359495 | Julie Ann Schroeder | Internal Medicine | 14370 Guthrie Ave, Apple Valley, MN 55124-6729 | 2020-06-03 |
| 1023644069 | Jeffrey Howard Mandel | Internal Medicine | 6204 Westridge Blvd, Edina, MN 55436-2569 | 2020-03-22 |
| 1861032054 | David Gregg | Internal Medicine | 5305 Humboldt Ave S, Minneapolis, MN 55419 | 2020-01-15 |
| 1467969907 | Minneapolis Health Clinic Pllc | Internal Medicine | 4825 Olson Memorial Hwy., Suite 101, Golden Valley, MN 55422 | 2018-01-05 |
| 1316454077 | Independent Medical Clinic Pa | Internal Medicine | 2639 Nicollet Ave Ste 120, Minneapolis, MN 55408-1629 | 2018-01-03 |
| 1669905618 | Joseph Douglas Steffens | Internal Medicine | 701 Park Avenue, Internal Medicine Residency Program, Hennepin County Medical Center, Minneapolis, MN 55415 | 2017-04-06 |
| 1841650306 | Megan Mcgovern | Internal Medicine | 701 Park Ave # O1.340, Minneapolis, MN 55415-1623 | 2016-02-26 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1700266079 | Jacob Wagner | Internal Medicine | D638 Mayo Building, 420 Delaware St Se, Minneapolis, MN 55455 | 2015-06-02 |
| 1659750503 | Melissa Ann Plesac | Internal Medicine | 500 Harvard St Se # 741, Minneapolis, MN 55455 | 2015-05-26 |
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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.