MEDICARE: JAMES T PACALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35965	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	768289	OTHER	MN	ARAZ
2	01-12876	OTHER	MN	MEDICA CHOICE
3	100591	OTHER	MN	UCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	HP16908	OTHER	MN	HEALTH PARTNERS
8	1009624	OTHER	MN	PREFERRED ONE
9	10G22PA	OTHER	MN	BLUE CROSS BLUE SHIELD
10	01-10796	OTHER	MN	MEDICA PRIMARY

General Provider Information

NPI Number	:	1689759599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES T PACALA MD

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:	UNIVERSITY OF MINNESOTA PHYSICIANS
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414
Country	:	US
Telephone Number	:	612-884-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 E 28TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1394
Country	:	US
Telephone Number	:	612-333-0770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	02/20/2013

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