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GREGORY M VERCELLOTTI MD NPI 1912008921


NPI Information

NPI: 1912008921
Provider Name: GREGORY M VERCELLOTTI, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Organization: FAIRVIEW CLINICS

PECOS Registration: Yes

Address:
424 HARVARD STREET SE
MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100
MINNEAPOLIS, MN
ZIP 55455
Phone: (612) 625-5411
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Gregory M Vercellotti, MD is a hematology and oncology internal medicine in Minneapolis, MN with 48 years of experience. The provider is 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. Gregory M Vercellotti, MD NPI is 1912008921. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:1976

The provider's business location address is:

424 HARVARD STREET SE
MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100
MINNEAPOLIS, MN
ZIP 55455
Phone: (612) 625-5411

The NPI 1912008921 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 9/25/2006 and was last updated on 12/1/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine25121MINNESOTANo
2207RH0003XInternal MedicineHematology & Oncology25121MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1090100OTHERMINNESOTAFAIRVIEW
23624552OTHERMINNESOTAMEDICA - CHOICE
33674562OTHERMINNESOTAMEDICA - PRIMARY
41009342OTHERMINNESOTAPREFERREDONE
5830001706MEDICARE ID-TYPE UNSPECIFIEDMINNESOTARAILROAD
6100794OTHERMINNESOTAUCARE
72T188VEOTHERMINNESOTABLUE CROSS BLUE SHIELD
8HP22082OTHERMINNESOTAHEALTHPARTNERS
9525815OTHERMINNESOTAARAZ
10927205400MEDICAIDMINNESOTA
11830000176MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.