Midwest Podiatry Centers Richfield - Medicare Podiatrist in Minneapolis, MN

Midwest Podiatry Centers Richfield is a medicare enrolled "Podiatrist" provider in Minneapolis, Minnesota. Their current practice location is 6625 Lyndale Ave S Ste 105, Minneapolis, Minnesota. You can reach out to their office (for appointments etc.) via phone at (612) 788-8778.

Midwest Podiatry Centers Richfield is licensed to practice in Minnesota (license number 631) and it also participates in the medicare program. Midwest Podiatry Centers Richfield is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1689848392.

Contact Information

Midwest Podiatry Centers Richfield
6625 Lyndale Ave S Ste 105,
Minneapolis, MN 55423-2673
(612) 788-8778
(612) 869-3473

Map and Direction




Healthcare Provider's Profile

Full NameMidwest Podiatry Centers Richfield
TypeFacility
SpecialityPodiatrist
Location6625 Lyndale Ave S Ste 105, Minneapolis, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689848392
  • Provider Enumeration Date: 04/15/2008
  • Last Update Date: 11/01/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 1254401300
  • Enrollment ID: O20080602000720

Medical Identifiers

Medical identifiers for Midwest Podiatry Centers Richfield such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689848392NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2134 (Minnesota)Secondary
213E00000XPodiatrist 631 (Minnesota)Primary
335E00000XProsthetic/orthotic Supplier 631 (Minnesota)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Midwest Podiatry Centers Richfield acts as a billing entity for following providers:
Provider NameDale Herbert Vancil
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1205856713
PECOS PAC ID: 5395649578
Enrollment ID: I20031120000214
Provider NameMark D Homstad
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1043289580
PECOS PAC ID: 2264346923
Enrollment ID: I20040329000357
Provider NameMichael Debrule
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1689655722
PECOS PAC ID: 4082695747
Enrollment ID: I20040527001000
Provider NameScott C Knutson
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1679578157
PECOS PAC ID: 3779528831
Enrollment ID: I20060425000406
Provider NameGlenn R Meints
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1265514731
PECOS PAC ID: 2062512304
Enrollment ID: I20070716000272
Provider NameDana Brewington
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1205933553
PECOS PAC ID: 5294735239
Enrollment ID: I20071018000104
Provider NameBryan Mohr
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1043215528
PECOS PAC ID: 8527070937
Enrollment ID: I20080602000712
Provider NameDavid Edward Jones
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1639163405
PECOS PAC ID: 6507824778
Enrollment ID: I20110203001135
Provider NameEric W Affeldt
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1225144850
PECOS PAC ID: 6709062698
Enrollment ID: I20110510000474
Provider NameMary E Jaeger
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1891129425
PECOS PAC ID: 4385867142
Enrollment ID: I20140523000225
Provider NameEric Nelson
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1184028193
PECOS PAC ID: 4880963628
Enrollment ID: I20170710002846
Provider NameKarimah Z Shabazz
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1134412802
PECOS PAC ID: 3577881697
Enrollment ID: I20180612000561
Provider NameTodd Aaron Peabody
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1750720876
PECOS PAC ID: 9739471939
Enrollment ID: I20180731000630
Provider NameBrent James Larson
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1659759082
PECOS PAC ID: 2062762479
Enrollment ID: I20180906000273
Provider NameLisa M Thatcher
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1922450618
PECOS PAC ID: 2365785904
Enrollment ID: I20190522000663
Provider NameMarlene Bonilla Alicea
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1588856546
PECOS PAC ID: 9436316817
Enrollment ID: I20190613000730
Provider NameDarrick William Proehl
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1629417506
PECOS PAC ID: 2365768504
Enrollment ID: I20191008000107
Provider NameKristofor Kalvig
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1558898114
PECOS PAC ID: 9638595267
Enrollment ID: I20200813001683
Provider NameAmanda Mcguire
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1124470745
PECOS PAC ID: 9335478015
Enrollment ID: I20210610002219
Provider NameNicholas Staub
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1790274066
PECOS PAC ID: 8921404690
Enrollment ID: I20210903000541
Provider NameTran Bao Nguyen
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1326600123
PECOS PAC ID: 7911389051
Enrollment ID: I20220805000281
Provider NameMichael Lee Vallez
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1215440854
PECOS PAC ID: 5294106977
Enrollment ID: I20230116000981
Provider NameJohn Matthew Thomas
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1033471990
PECOS PAC ID: 9032417829
Enrollment ID: I20230831002859

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Midwest Podiatry Centers Richfield is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Midwest Podiatry Centers Richfield
6625 Lyndale Ave S Ste 300,
Minneapolis, MN 55423-2491

Ph: (612) 788-8778
Midwest Podiatry Centers Richfield
6625 Lyndale Ave S Ste 105,
Minneapolis, MN 55423-2673

Ph: (612) 788-8778

Reviews and Comments


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