| Intermed Consultants,ltd. | |
|
6600 France Ave S Ste 162 Edina MN 55435-1802 | |
| (952) 920-2070 | |
| (952) 920-7444 |
| Full Name | Intermed Consultants,ltd. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6600 France Ave S Ste 162, Edina, Minnesota |
| Authorized Official Name and Position | David L Bowlin (PRESIDENT) |
| Authorized Official Contact | 9529202070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermed Consultants,ltd. 6363 France Ave S Suite 400 Edina MN 55435-2129 Ph: (952) 920-2070 | Intermed Consultants,ltd. 6600 France Ave S Ste 162 Edina MN 55435-1802 Ph: (952) 920-2070 |
| NPI Number | 1962596221 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Medicare PECOS PAC ID | 8022033372 |
|---|---|
| Medicare Enrollment ID | O20051006000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962596221 | NPI | - | NPPES |
| 222718500 | Medicaid | MN | |
| 52581 | Other | MN | HEALTHPARTNERS |
| CE0723 | Other | MN | RAILROAD MEDICARE |
| 33Q83IN | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (NU) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (NU) | Primary |
| Provider Name | Rajiv R Shah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1366556854 PECOS PAC ID: 9638138720 Enrollment ID: I20041005000683 |
| Provider Name | Keith E Eidman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1174579437 PECOS PAC ID: 8628024411 Enrollment ID: I20050324000564 |
| Provider Name | Sara M Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659494235 PECOS PAC ID: 5890886683 Enrollment ID: I20070808000566 |
| Provider Name | Jonathan Peter Tolins |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194830463 PECOS PAC ID: 2860588076 Enrollment ID: I20071019000111 |
| Provider Name | David L Bowlin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003922667 PECOS PAC ID: 9537184882 Enrollment ID: I20080326000189 |
| Provider Name | George Thomas Obryan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417061904 PECOS PAC ID: 1456262252 Enrollment ID: I20100128000977 |
| Provider Name | Steven M Dittes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770593089 PECOS PAC ID: 0446275796 Enrollment ID: I20100524000499 |
| Provider Name | Melissa F Hall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962737981 PECOS PAC ID: 4082759261 Enrollment ID: I20110404000624 |
| Provider Name | Dipi Sharma |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841451135 PECOS PAC ID: 1759525108 Enrollment ID: I20130925000130 |
| Provider Name | Evan M Burgart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255619813 PECOS PAC ID: 2365615531 Enrollment ID: I20140421001841 |
| Provider Name | Oliver T Phan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942463229 PECOS PAC ID: 4082862909 Enrollment ID: I20140630002198 |
| Provider Name | Sadia Ali |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164632766 PECOS PAC ID: 5698859064 Enrollment ID: I20160808002373 |
| Provider Name | Jiwan K Thapa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518123355 PECOS PAC ID: 1052555901 Enrollment ID: I20170816002014 |
| Provider Name | Erin M Gottesleben |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346706645 PECOS PAC ID: 6204178650 Enrollment ID: I20190503002231 |
| Provider Name | Jacqueline F Roff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629480850 PECOS PAC ID: 7618376716 Enrollment ID: I20210521001406 |
| Provider Name | Teija Madhusoodanan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902338791 PECOS PAC ID: 2365712973 Enrollment ID: I20220912002302 |
| Provider Name | Thomas Edward Schmidt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215557202 PECOS PAC ID: 5496160202 Enrollment ID: I20250725002573 |
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