MAYO CLINIC

Provider Demographics

• NPI: 1922074434
• Name: MAYO CLINIC
• Entity Type: Organization
• Organization Name: MAYO CLINIC
• Authorized Official - Title/Position: CHIEF FINANCIAL OFFICER
• Authorized Official - Prefix: MR
• Authorized Official - First Name: DENNIS
• Authorized Official - Last Name: DAHLEN
• Authorized Official - Phone: 507-538-3389
• Mailing Address - Street 1: 200 1ST ST SW
• Mailing Address - City: ROCHESTER
• Mailing Address - State: MN
• Mailing Address - Zip Code: 55905-0001
• Mailing Address - Country: US
• Mailing Address - Phone: 507-284-2511
• Mailing Address - Fax: 507-284-0574
• Practice Address - Street 1: 200 1ST ST SW
• Practice Address - City: ROCHESTER
• Practice Address - State: MN
• Practice Address - Zip Code: 55905-0001
• Practice Address - Country: US
• Practice Address - Phone: 507-284-2511
• Practice Address - Fax: 507-284-0574
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-02-24
• Last Update Date: 2023-07-06

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	261QM1300X	Ambulatory Health Care Facilities	Clinic/Center	Multi-Specialty
No	207RG0100X	Allopathic & Osteopathic Physicians	Internal Medicine	Gastroenterology	Group - Multi-Specialty
No	208D00000X	Allopathic & Osteopathic Physicians	General Practice		Group - Multi-Specialty
No	291U00000X	Laboratories	Clinical Medical Laboratory
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MN	C01384	Medicare Oscar/Certification
AZ	Z143877	Medicare Oscar/Certification
FL	ER478A	Medicare Oscar/Certification
MN	0530520001	Medicare NSC
WI	000020345	Medicare Oscar/Certification
IA	I19223	Medicare Oscar/Certification
MN	690003575	Medicare ID - Type Unspecified
MN	854717300	Medicaid
IA	902528	Medicaid
MN	279722400	Medicaid
MN	75264300	Medicaid
MN	234853500	Medicaid
AZ	Z143877	Medicare Oscar/Certification
MN	C47512	Medicare ID - Type Unspecified
MN	DC8613	Medicare ID - Type Unspecified
MN	CD8386	Medicare ID - Type Unspecified
MN	702712500	Medicaid
MN	381526900	Medicaid
ND	10226	Medicaid
SD	7760190	Medicaid
MN	100517100	Medicaid
MN	0530520001	Medicare NSC