NPIMap

Individual provider Active NPI

Douglas Dworak, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Woodbury, MN
National Provider Identifier
1033408299
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
60044 Issued in MN
Practice address
2080 Woodwinds Dr Ste 110
Woodbury, MN 55125
Phone
(651) 738-6500
Fax
(651) 714-6997
NPI assigned
Mar 28, 2011
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 60044 MN Primary

Addresses

Primary practice location

2080 Woodwinds Dr Ste 110
Woodbury, MN 55125

Mailing address

2080 Woodwinds Dr Ste 110
Woodbury, MN 55125-2537
Phone (651) 738-6800

Other practice location 1

27450 Schoenherr Rd
Ste. 200
Warren, MI 48088-6683
Phone (586) 582-7860

Other identifiers 2

IdentifierTypeStateIssuer
1720173651OtherMNTYPE 2 NPI
1033408299OtherMNNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160606001432 MN Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 3577875301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Eye Clinic PAGroup PAC ID 6709773823, 20 clinicians

Practice addresses (Care Compare)

1215 Town Centre Dr
Suite 100
Eagan, MN 55123-1356
Phone (651) 454-2526

1675 Beam Ave
Suite 100
Maplewood, MN 55109-1478
Phone (651) 770-2904

2080 Woodwinds Dr
Suite 230
Woodbury, MN 55125-2539
Phone (651) 578-6949

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.92 of 100Reported as group
Quality
89.37
Promoting interoperability
100
Improvement activities
40
Cost
73.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Eye Clinic PA CurrentSince Jul 18, 2016 Accepting new patients
St Paul Eye Clinic PA CurrentSince Jul 18, 2016 Accepting new patients

Locations

1215 Town Centre Dr
Ste 100
Eagan, MN 55123
Phone (651) 454-2526

1675 Beam Ave
Ste 100
Maplewood, MN 55109
Phone (651) 227-6634

2680 Snelling Ave N
Ste 110
Roseville, MN 55113
Phone (651) 631-2922

1093 Grand Ave
Saint Paul, MN 55105
Phone (651) 222-7343

5945 Norwich Ave N
Stillwater, MN 55082
Phone (651) 351-2038

2080 Woodwinds Dr
Ste 110
Woodbury, MN 55125
Phone (651) 738-6500

2080 Woodwinds Dr
Ste 230
Woodbury, MN 55125
Phone (651) 578-6949

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1033408299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252537",
            "telephone_number": "651-738-6800",
            "fax_number": "586-582-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-738-6500",
            "fax_number": "651-714-6997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27450 Schoenherr Rd",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480886683",
            "country_code": "US",
            "telephone_number": "586-582-7860",
            "fax_number": "586-582-7861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWORAK",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "60044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI",
            "identifier": "1720173651",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033408299",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.