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

Gary Alan Nisius, MD

Individual provider Family Medicine Physician · NPI 1518995042

Gary Alan Nisius, MD is a Family Practice in Plymouth, Minnesota. Graduated from University of Minnesota Medical School in 1998, 28 years ago. Practices with North Clinic PA, a 49-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
28
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15655 37th Ave N Ste 100
Plymouth, MN 55446-4003
Phone: (763) 587-7900
Fax: (763) 587-7701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 41693 (MN)

Record details

NPI number1518995042
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 30, 2006
Last updated in NPPESNovember 8, 2022
Certification dateNovember 8, 2022
Mailing address9201 W Broadway Ave Ste 601, Brooklyn Park, MN 55445-1924

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 1998 (28 years in practice)
Group practice North Clinic Pa — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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