PAUL W SPERDUTO (NPI# 1891789053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891789053 |
| Entity Type | Individual |
| Full Name | PAUL W SPERDUTO |
| Credential | MD |
| Practice Address |
490 S Maple St # 117 Waconia MN 55387-1760 |
| Mailing Address |
6950 France Ave S # 200 Edina MN 55435-2008 |
| Practice Telephone | 9524426000 |
| Practice Fax Number | 9524426004 |
| Mailing Telephone | 9529204915 |
| Mailing Fax Number | 9529156091 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
34957 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTH PARTNERS | HP14452 | 01 |
| MN | PT CHOICE | 104527 | 01 |
| MN | PREFERRED ONE | 963071000190 | 01 |
| MN | UCARE | 100685 | 01 |
| WI | 32721200 | 05 | |
| MN | AMERICA'S PPO | 25142 | 01 |
| MN | MEDICA | 24-28410 | 01 |
| MN | MEDICA PRIMARY | 24-00004 | 01 |
| MN | BLUE CROOS/BLUE SHIELD | 2M662SP | 01 |
| Street Address |
490 S MAPLE ST # 117 |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346682473 | Roxy Exner | Nurse Practitioner | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2013-07-17 |
| 1770726671 | Ridgeview Clinics | Internal Medicine | 490 S Maple St, Suite 204, Waconia, MN 55387-1760 | 2009-04-08 |
| 1891969044 | Urology Associates, Ltd. | Urology | 490 S Maple St, Suite 204, Waconia, MN 55387-1760 | 2008-04-18 |
| 1225249881 | Ridgeview Clinics | Internal Medicine | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2007-05-25 |
| 1912015942 | John W Meccia | Otolaryngology | 490 S Maple St, Suite 205, Waconia, MN 55387-1760 | 2006-08-29 |
| 1497863401 | John W Larsen | Otolaryngology | 490 S Maple St, Suite 205, Waconia, MN 55387-1760 | 2006-08-29 |
| 1548225402 | Western Orthopaedic & Sports Medicine Consultants, P.a. | Specialist | 490 S Maple St, Waconia, MN 55387-1760 | 2006-04-20 |
| 1033173331 | Total Renal Care Inc | Clinic/Center | 490 S Maple St, Suite 110, Waconia, MN 55387-1760 | 2006-04-13 |
| 1184691826 | Ravi Vaela | Internal Medicine | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669031423 | Kai Jiang | Radiology | 617 4th St Sw Apt 3, Rochester, MN 55902-3286 | 2019-06-06 |
| 1508205311 | Somu Suppiah | Radiology | 6500 Excelsior Blvd Dept Of, St Louis Park, MN 55426 | 2013-06-14 |
| 1063858769 | Sumit Sean Sood | Radiology | 5160 Fairview Blvd Ste 1100, Wyoming, MN 55092-8050 | 2013-05-21 |
| 1831535863 | Megan Gentry Hodges | Radiology | 1900 Centracare Circle #1600, Centracare Clinic Health Plaza Radiology/oncology, St Cloud, MN 56303-5000 | 2013-05-16 |
| 1679838403 | Richard Lee | Radiology | 701 Park Ave # G1, Minneapolis, MN 55415-1623 | 2012-07-09 |
| 1396909404 | James Lee Ecker | Radiology | 10448 Vera Cruz Dr N, Brooklyn Park, MN 55443-2555 | 2008-07-17 |
| 1275627820 | Xin Wang | Radiology | The Center for Prostate Cancer, 420 Delaware Street Se, Mayo Building, Fourth Floor, Minneapolis, MN 55455 | 2006-10-03 |
| 1295759009 | Gregory Evan Meyers | Radiology | 6950 France Ave S Ste 200, Edina, MN 55435-2025 | 2006-07-26 |
| 1770526188 | Nathan Earl Hilton | Radiology | 215 Ivy St, Brainerd, MN 56401-3000 | 2006-06-14 |
| 1124082136 | Janel A Cox | Radiology | 631 Goodrich Ave, Saint Paul, MN 55105-3522 | 2006-04-14 |
| Find all providers with the same taxonomy | ||||
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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.