TIMOTHY J GAVIN M.D. NPI 1528004587

NPI Information

NPI: 1528004587
Provider Name: TIMOTHY J GAVIN, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
6405 FRANCE AVE S
SUITE W440
EDINA, MN
ZIP 55435
Phone: (952) 927-7004
Get Directions

Timothy J Gavin, M.D. is a vascular surgery surgery in Edina, MN with 35 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Timothy J Gavin, M.D. NPI is 1528004587. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF WISCONSIN
Graduation Year:1989

The provider's business location address is:

6405 FRANCE AVE S
SUITE W440
EDINA, MN
ZIP 55435-163
Phone: (952) 927-7004
Fax: (952) 927-5146

The NPI 1528004587 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		47505	MINNESOTA	No
2	2086S0129X	Surgery	Vascular Surgery	47505	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00217949	OTHER	MINNESOTA	MEDICARE RAILROAD
2	47505	OTHER	MINNESOTA	MN LICENSE
3	HP50655	OTHER	MINNESOTA	HEALTHPARTNERS
4	2341371	OTHER	MINNESOTA	AMERICA'S PPO
5	766110000	MEDICAID	MINNESOTA
6	961901043279	OTHER	MINNESOTA	PREFERREDONE
7	993N5GA	OTHER	MINNESOTA	BLUECROSS/BLUESHIELD MN
8	3700049	OTHER	MINNESOTA	MEDICA
9	181292	OTHER	MINNESOTA	UCARE MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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