DR. BART THEODORE ENDRIZZI (M.D/PH.D.) – MOHS-Micrographic Surgery Physician, NPI 1235323585

DR. BART THEODORE ENDRIZZI (M.D/PH.D.) is a healthcare provider. based in Minneapolis, Minnesota. specializing in DERMATOLOGY, MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). They hold the professional credentials M.D/PH.D.. They hold a License No. 52206 (MN). The NPI Number for DR. BART THEODORE ENDRIZZI (M.D/PH.D.) is 1235323585

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. BART THEODORE ENDRIZZI (M.D/PH.D.)
NPI
1235323585
Phone
(612) 625-8625
Address
420 DELAWARE ST SE
Enumeration Date
29 August 2007
Last Update Date
22 August 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
6517899800809
Graduation Year
2005 (21 years ago)
PAC ID
2062551708
Group Practice PAC ID
4688815343
Professional Enrollment ID
I20091209000355
Address ID
MN551277093NO400XXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

419 DERMATOLOGY in MN

Provider Addresses for DR. BART THEODORE ENDRIZZI (M.D/PH.D.)

  • 420 DELAWARE ST SE

    MINNEAPOLIS, MN 554550341

    Phone: (612) 625-8625

    Type: Location

  • Washington Avenue Southeast, Prospect Park - East River Road, Minneapolis, Hennepin County, Minnesota, 55414, United States

    UNIVERSITY OF MINNESOTA PHYSICIANS

    MINNEAPOLIS, MN 55414

    Phone: (612) 884-0649

    Type: Mailing

  • 500 OSBORNE RD NE STE 330

    FRIDLEY, MN 554322769

    Phone: (763) 571-4000

    Type: Location

  • 119 14TH ST NW STE 240

    NEW BRIGHTON, MN 551120007

    Phone: (763) 571-4000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $424.

Total Amount is formed as General ($424) + Research ($0) + Ownership ($0) = $424.

Last reported payment date: 2024-09-04 • Largest payer in this snapshot: Janssen Biotech, Inc. ($66).

Total Amount

$424

General + Research + Ownership

Payments

24

Total payment records

General Amount

$424

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20091209000355IMicrographic Dermatologic Surgery (Mds)MNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks478351$0
17003Destruction of precancer skin growth, 2-14 growths30960$0
17312Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks228146$0
88331Pathology examination of specimen during surgery, first tissue block12275$0
13132Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm116108$0
View full utilization report →

Insurance plans in this area (ZIP 55455)

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Provider's Procedures

DR. BART THEODORE ENDRIZZI (M.D/PH.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYMN14060Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips1818
DERMATOLOGYMN17003Destruction of 2-14 skin growths40976

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688815343View full group profile
NameSpecialtyState
D E R M A T O L O G YMN
D E R M A T O L O G YMN
Physician AssistantMN
Physician AssistantMN

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Frequently asked questions

What identifier follows DR. BART THEODORE ENDRIZZI (M.D/PH.D.) across health systems?
The NPI 1235323585 uniquely identifies DR. BART THEODORE ENDRIZZI (M.D/PH.D.) in U.S. healthcare data.
Is DR. BART THEODORE ENDRIZZI (M.D/PH.D.) currently accepting referrals based on NPI status?
Registry metadata lists DR. BART THEODORE ENDRIZZI (M.D/PH.D.) as active.
How should patients interpret DR. BART THEODORE ENDRIZZI (M.D/PH.D.)'s specialty?
The extract shows MOHS-Micrographic Surgery Physician for DR. BART THEODORE ENDRIZZI (M.D/PH.D.). Clinical services aligned with this taxonomy classification.
Can patients visit DR. BART THEODORE ENDRIZZI (M.D/PH.D.) in Minneapolis, Minnesota?
For routing, start with Minneapolis, Minnesota for DR. BART THEODORE ENDRIZZI (M.D/PH.D.), then verify phone and hours locally.
Can I export DR. BART THEODORE ENDRIZZI (M.D/PH.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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