Healthcare Provider Details

I. General information

NPI: 1407048416
Provider Name (Legal Business Name): MICHAEL JAY MCCABE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL JAY LEFFLER-MCCABE

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 FULTON ST SE
MINNEAPOLIS MN
55455-4800
US

IV. Provider business mailing address

3601 MINNESOTA DR STE 200
BLOOMINGTON MN
55435-5202
US

V. Phone/Fax

Practice location:
  • Phone: 612-672-7422
  • Fax:
Mailing address:
  • Phone: 612-879-1000
  • Fax: 612-879-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number53939
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number53939
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: