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Organization

INSPIRIS OF NEW YORK IPA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN O. ENDERLE (SR. VICE PRESIDENT)
(860) 221-0793
Entity
Organization

Contact information

Practice address
11020 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(615) 224-5440
Mailing address
11020 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(615) 224-5440

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
363AM0700X
Medical Physician Assistant
363LA2200X
Adult Health Nurse Practitioner
363LG0600X
Gerontology Nurse Practitioner
Primary

Other

Enumeration date
03/06/2015
Last updated
06/16/2015
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