Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Noennig

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699192997

Blake Noennig is an Urology in St Louis Park, Minnesota. Graduated from University of Minnesota Medical School in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone: (952) 993-3123
Fax: (952) 993-3286
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1600 Sw Archer Rd, Gainesville, FL 32610-0247 — (352) 273-8634
  • 1600 Sw Archer Rd, Gainesville, FL 32610-0247 — (352) 273-8634

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 65775 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1699192997
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 25, 2014
Last updated in NPPESJuly 19, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations11 on file with Medicare

Other providers in St Louis Park