MINNESOTA ONCOLOGY HEMATOLOGY, PA (NPI# 1619111705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619111705 |
| Entity Type | Organization |
| Organization Name | MINNESOTA ONCOLOGY HEMATOLOGY, PA |
| Practice Address |
11850 Blackfoot Nw Suite 100 Coon Rapids MN 55433-2569 |
| Practice Telephone | 7637122100 |
| Practice Fax Number | 7637122190 |
| Mailing Telephone | 7637122100 |
| Mailing Fax Number | 7637122190 |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2013-12-20 |
| Authorized Official Name | DR. DEAN GESME (PRESIDENT) |
| Authorized Official Telephone | 6128846300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | 1076 | MN | Dietary & Nutritional Service Providers |
| N | 170300000X | Genetic Counselor, MS | 1076 | MN | Other Service Providers |
| N | 207R00000X | Internal Medicine | 1076 | MN | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1076 | MN | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
1076 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1076 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 1076 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364S00000X | Clinical Nurse Specialist | 1076 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE ID | C01828 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770123697 | Minnesota Oncology Hematology, Pa | Radiology | 1580 Beam Ave, Saint Paul, MN 55109-1127 | 2020-01-08 |
| 1598305427 | Minnesota Oncology Hematology, Pa | Radiology | 345 Sherman St Ste 100, Saint Paul, MN 55102-2401 | 2020-01-08 |
| 1114430089 | Minnesota Oncology Hematology, Pa | Internal Medicine | 6025 Lake Rd Ste 200, Woodbury, MN 55125-1710 | 2017-11-14 |
| 1881130417 | Minnesota Oncology Hematology, Pa | Internal Medicine | 601 W Chandler St, Arlington, MN 55307-2127 | 2017-01-06 |
| 1356585442 | Minnesota Oncology Hematology, Pa | Internal Medicine | 480 Osborne Rd Ne, Suite 220, Fridley, MN 55432 | 2009-04-21 |
| 1447409834 | Minnesota Oncology Hematology, Pa | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2008-09-10 |
| 1851569909 | Minnesota Oncology Hematology, Pa | Physician Assistant | 6363 France Ave S, Suite 200, Edina, MN 55435-2129 | 2008-02-12 |
| 1609911205 | Minnesota Oncology Hematology, Pa | Dietitian, Registered | 345 Sherman St, Suite 100, Saint Paul, MN 55102-2401 | 2007-02-21 |
| 1447394424 | Minnesota Oncology Hematology, Pa | Dietitian, Registered | 560 S Maple St, Suite 100, Waconia, MN 55387-1760 | 2007-02-16 |
| 1467595868 | Minnesota Oncology Hematology, Pa | Nurse Practitioner | 675 E Nicollet Blvd Ste 100, Burnsville, MN 55337-6749 | 2007-02-15 |
| Street Address |
11850 BLACKFOOT NW SUITE 100 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619941804 | Rajini Katipamula Malisetti | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-02-14 |
| 1649424078 | Tiffaney Jo Hammer | Physician Assistant | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2008-11-12 |
| 1083706964 | Gauri Nagargoje | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-09-29 |
| 1235221110 | Noel Laudi | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194817072 | Robert D Winston | Internal Medicine | 3960 Coon Rapids Blvd, Suite 311, Coon Rapids, MN 55433 | 2006-09-29 |
| 1821008996 | Joseph Michael Cardamone Jr. | Internal Medicine | 11850 Blackfoot Ne, Suite 100, Coon Rapids, MN 55433-2598 | 2006-08-09 |
| 1619941804 | Rajini Katipamula Malisetti | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-02-14 |
| 1083706964 | Gauri Nagargoje | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-09-29 |
| 1235221110 | Noel Laudi | Internal Medicine | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2006-09-29 |
| 1104836154 | Lucia Astrid Garino | Internal Medicine | 11850 Blackfoot St Nw, Suite 100, Coon Rapids, MN 55433-2598 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780041301 | Nicole Jacobi | Internal Medicine | 701 Park Avenue Mail Code O1.340, Minneapolis, MN 55415-1623 | 2016-01-27 |
| 1366691636 | Laxmidas Anant Sawkar | Internal Medicine | 11376 Sandcastle Dr, Woodbury, MN 55129-8562 | 2008-09-11 |
| 1669628517 | Howard Clark Hoagland | Internal Medicine | 1705 Folwell Dr Sw, Rochester, MN 55902-0987 | 2008-08-12 |
| 1366626343 | Hilary Ikenna Ufearo | Internal Medicine | 1900 Centracare Circle, #1600, Centracare Clinic Health Plaza Specialties/oncology, St Cloud, MN 56303-5000 | 2007-12-26 |
| 1598851198 | Douglas Yee | Internal Medicine | Masonic Cancer Center, First Floor, Suite M100, 424 Harvard Street Se, Minneapolis, MN 55455 | 2006-10-04 |
| 1073605952 | John Manion | Internal Medicine | 3435 West Broadway, Suite 1065, Robbinsdale, MN 55422 | 2006-09-29 |
| 1023111531 | Ayse Malcolm | Internal Medicine | 1455 St. Francis Avenue, St. Francis Regional Medical Center, Shakopee, MN 55379-3380 | 2006-09-07 |
| 1134135106 | Kendra L. Kubiak | Internal Medicine | 3931 Louisiana Avenue, St Louis Park, MN 55426 | 2006-07-31 |
| 1093760290 | Girum L Lemma | Internal Medicine | 6025 Lake Rd Ste 110, Woodbury, MN 55125-1709 | 2006-05-24 |
| 1205808466 | Paul J Thurmes | Internal Medicine | 910 E 26th St Ste 100, Minneapolis, MN 55404-4552 | 2006-02-02 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.