Basic Information
Provider Information | |||||||||
NPI: | 1548211485 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SCHMITZ-BURNS | ||||||||
FirstName: | SARAH | ||||||||
MiddleName: | BERNICE | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 801 NICOLLET MALL | ||||||||
Address2: | SUITE 400 | ||||||||
City: | MINNEAPOLIS | ||||||||
State: | MN | ||||||||
PostalCode: | 554022500 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6123332503 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 801 NICOLLET MALL | ||||||||
Address2: | SUITE 400 | ||||||||
City: | MINNEAPOLIS | ||||||||
State: | MN | ||||||||
PostalCode: | 554022500 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6123332503 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/15/2006 | ||||||||
LastUpdateDate: | 04/23/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/23/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 47453 | MN | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 132871D686 | 01 | MN | UCARE | OTHER | 2362907 | 01 | MN | AMERICA'S PPO | OTHER | FP9041043944 | 01 | MN | PREFERRED ONE | OTHER | 068483000 | 05 | MN |   | MEDICAID | 0700065 | 01 | MN | MEDICA DUAL/MEDICARE MA | OTHER | 1548211485 | 01 | MN | NPI | OTHER | 34646000 | 05 | WI |   | MEDICAID | 346G5SC | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | HP52382 | 01 | MN | HEALTH PARTNERS | OTHER | 0704934 | 01 | MN | MEDICA | OTHER |