MINNESOTA ORTHOPAEDIC SURGERY CENTER LLC (NPI# 1548219397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548219397 |
| Entity Type | Organization |
| Organization Name | MINNESOTA ORTHOPAEDIC SURGERY CENTER LLC |
| Practice Address |
8290 University Ave Ne Suite 100 Fridley MN 55432-1847 |
| Practice Telephone | 7637860461 |
| Practice Fax Number | 7637860471 |
| Mailing Telephone | 7637860461 |
| Mailing Fax Number | 7637860471 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2012-05-22 |
| Authorized Official Name | DR. PETER D HOLMBERG (PRESIDENT) |
| Authorized Official Telephone | 7637869543 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS/BLUE SHIELD | 7Y16MI | 01 |
| MN | PREFERRED ONE | 1021808 | 01 |
| MN | 726170500 | 05 |
| Street Address |
8290 UNIVERSITY AVE NE SUITE 100 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-1847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588638514 | Amy C Lindell | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2006-02-15 |
| 1568999126 | Peter D Fitzgerald | Physician Assistant | 8290 University Ave Ne, Fridley, MN 55432-1847 | 2017-05-15 |
| 1912358219 | Kelli Michelle Cannata | Physician Assistant | 8290 University Ave Ne, Ste 200, Fridley, MN 55432-1847 | 2016-06-28 |
| 1245614247 | Jenna Evelyn Walker | Occupational Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2015-07-20 |
| 1891101838 | Katie Mclaughlin | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2014-07-10 |
| 1477973246 | Taylor James Ridley | Orthopaedic Surgery | 8290 University Ave Ne, Fridley, MN 55432-1847 | 2014-04-21 |
| 1730515719 | Bryan D Dejarlais | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2013-09-23 |
| 1205277571 | Nea Rae Bennington | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2013-07-15 |
| 1699010132 | Seth David Engberg | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2012-12-11 |
| 1760726053 | Kristina L Withers | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2012-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194105841 | Pain Centers of Minnesota - Fridley, LLC | Clinic/Center | 480 Osborne Rd Ne, Suite 260, Fridley, MN 55432-2773 | 2015-06-08 |
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|---|---|---|---|---|
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1902410368 | Inspired Spine Surgcenter LLC | Clinic/Center | 7400 France Ave S Ste 102, Edina, MN 55435-4738 | 2020-09-03 |
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1215573209 | Hiawatha Surgery Center LLC | Clinic/Center | 2020 E 28th St Ste 100, Minneapolis, MN 55407-1453 | 2019-11-25 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1942760285 | Altru Health System Ambulatory Surgery Centers LLC | Clinic/Center | 400 S Minnesota St Ste B, Crookston, MN 56716-1808 | 2019-03-22 |
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1891297925 | Pediatric Center Holdings, LLC | Clinic/Center | 15450 Highway 7 Ste 200, Minnetonka, MN 55345-3522 | 2018-03-05 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.