HEATHER E GANTZER (MD) – Internal Medicine Physician, NPI 1639154404

HEATHER E GANTZER (MD) is a healthcare provider. based in St louis park, Minnesota. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 31600 (MN). The NPI Number for HEATHER E GANTZER (MD) is 1639154404

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER E GANTZER (MD)
NPI
1639154404
Phone
Not provided
Address
6465 WAYZATA BLVD
Enumeration Date
14 December 2005
Last Update Date
10 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529938900
Graduation Year
1985 (41 years ago)
PAC ID
7618066127
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20071207000280
Address ID
MN554462307PL4155X101X400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,172 EMERGENCY MEDICINE in MN

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Provider Addresses for HEATHER E GANTZER (MD)

  • Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    SUITE 210

    ST LOUIS PARK, MN 554261728

    Phone:

    Type: Mailing

  • 3850, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    ST LOUIS PARK, MN 554162527

    Phone: (952) 993-2000

    Type: Location

  • 8170 33RD AVE S # MS 21110Q

    BLOOMINGTON, MN 554254516

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2007-12-07

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
I20071207000280IEmergency MedicineMNTBD

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
36415Insertion of needle into vein for collection of blood sample525221$0
99214Established patient office or other outpatient visit, 30-39 minutes241169$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit181181$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count181140$0
85610Blood test, clotting time16518$0
View full utilization report →

Insurance plans in this area (ZIP 55426)

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Provider's Procedures

HEATHER E GANTZER (MD) performs procedures in EMERGENCY MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINEMN85610Blood test, clotting time19525

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: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Can I verify HEATHER E GANTZER (MD) with an NPI only?
You can start verification with NPI 1639154404 for HEATHER E GANTZER (MD), then check state licensing separately.
Is HEATHER E GANTZER (MD) listed as active for patients and plans?
The listing shows HEATHER E GANTZER (MD) as active in the NPI system.
What healthcare role does HEATHER E GANTZER (MD) hold?
Scheduling teams often label HEATHER E GANTZER (MD) under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for HEATHER E GANTZER (MD)?
HEATHER E GANTZER (MD)'s geographic hint is St Louis Park, Minnesota in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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