MEDICARE: MICHAEL J LEGRIS M.D.

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	207RN0300X	Nephrology Physician	41665	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	839987	OTHER	MN	AMERICA'S PPO
2	HP28750	OTHER	MN	HEALTHPARTNERS
3	1020250	OTHER	MN	PREFERRED ONE
4	3100020	OTHER	MN	MEDICA
5	123453C028	OTHER	MN	UCARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	02F45LE	OTHER	MN	BCBSMN

General Provider Information

NPI Number	:	1780601567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J LEGRIS M.D.

Provider Business Mailing Address
First Line	:	6200 SHINGLE CREEK PKWY STE 260
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-561-5349
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 LYNDALE AVE S
Second Line	:	SUITE 220
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2477
Country	:	US
Telephone Number	:	612-823-8001
Fax Number	:	612-823-1010

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	01/15/2026

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Directions to “ MICHAEL J LEGRIS M.D.” Practice Location

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