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Deactivated NPI 1124073093 Deactivated / Inactive NPI Male Practitioner

Dr. Andre Nelson , MD

Specialist • Minneapolis, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Andre Nelson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 22, 2006
NPI Deactivation Date March 12, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Andre Nelson, MD was a registered Specialist practicing in Minneapolis, MN. Throughout an active medical career spanning 20 years, Dr. Nelson provided care at the practice location at 2545 CHICAGO AVE until profile deactivation on 2026-03-12.

Practice Location & Contact Primary Location

Practice Address

2545 Chicago Ave
Suite 512

Minneapolis, MN 554044522

Telephone 6128136475
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Minneapolis, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.8 Yrs
State Avg: 34.7 Yrs
Regional Practice Density
71 Specialists

Practicing in Minneapolis, MN (877 Statewide)

Telehealth Adoption Rate
4.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MN 18212

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners
Dr. Jeanne Mrozek , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1144274176

Doctor of Medicine (M.D.)

Dr. Mary Pylipow , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1215975073

Doctor of Medicine (M.D.)

Dr. David Brasel , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1225076052

Doctor of Medicine (M.D.)

Dr. James Moore , MD

Pediatrics - Developmental - Behavioral Pediatrics

NPI 1275624561

Doctor of Medicine (M.D.)

Dr. Nathaniel Payne , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1316992209

Doctor of Medicine (M.D.)

Dr. Virginia Hustead , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1417902396

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 12, 2026

Record deactivated on March 12, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2545 CHICAGO AVE, SUITE 512, MINNEAPOLIS, MN 554044522 (Tel: 6128136475)

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Updated Business Mailing Address July 08, 2007

Registered at 2545 CHICAGO AVE, SUITE 512, MINNEAPOLIS, MN 554044522 (Tel: 6128136475)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ANDRE NELSON, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #18212 in MN)

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Initial NPI Registration & Enumeration May 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124073093
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 22, 2006
Last Update: July 08, 2007
Deactivation Date: March 12, 2026

Mailing Address

2545 Chicago Ave, Suite 512

Minneapolis, MN 554044522

Phone: 6128136475

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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