| Ridgeview Medical Center | |
|
500 S Maple St Waconia MN 55387-1752 | |
| (952) 442-2191 | |
| (952) 442-8052 |
| Full Name | Ridgeview Medical Center |
|---|---|
| Speciality | Radiology |
| Location | 500 S Maple St, Waconia, Minnesota |
| Authorized Official Name and Position | Michael Phelps (CEO) |
| Authorized Official Contact | 9524422191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgeview Medical Center 500 S Maple St Waconia MN 55387-1752 Ph: (952) 442-2191 | Ridgeview Medical Center 500 S Maple St Waconia MN 55387-1752 Ph: (952) 442-2191 |
| NPI Number | 1811174923 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 12/08/2023 |
| Medicare PECOS PAC ID | 9234041997 |
|---|---|
| Medicare Enrollment ID | O20241108000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811174923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 48355 (Minnesota) | Primary |
| Provider Name | Sean K Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609052000 PECOS PAC ID: 7416088489 Enrollment ID: I20150722005536 |
| Provider Name | David M Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750721593 PECOS PAC ID: 5597075135 Enrollment ID: I20180711002291 |
| Provider Name | Everett H Gu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588004535 PECOS PAC ID: 5395055396 Enrollment ID: I20180730002537 |
| Provider Name | Timothy Meehan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558686030 PECOS PAC ID: 4486811395 Enrollment ID: I20241127000297 |
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Ridgeview Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 South Maple Street, Suite 220, Waconia, MN 55387 Phone: 952-442-8011 | |
Minneapolis Heart Institute At Ridgeview Heart Center, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 S Maple St, Waconia, MN 55387 Phone: 952-442-7843 |