NPIMap

Individual provider Active NPI

Melissa Marie Simonson, M.D.

  • Internal Medicine Physician
  • Duluth, MN
National Provider Identifier
1154559763
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53193 Issued in MN
Practice address
400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jun 23, 2009
Last updated
Oct 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21942 MN
Internal Medicine Physician 207R00000X 53193 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 3

IdentifierTypeStateIssuer
1154559763MedicaidMN
1154559763MedicaidMI
1154559763MedicaidWI

Other names 1

  • Melissa Marie Larson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120808000761 MN Practitioner - HospitalistPractitioner - Internal Medicine 5698921583 Reassigns benefits to 7 organizations
I20200424000093 WI Practitioner - Internal MedicinePractitioner - Hospitalist 5698921583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deer River Healthcare Center Inc CurrentSince Oct 1, 2021 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 29, 2013 Accepting new patients
Northern Pines Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Pine Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Deer River Healthcare Center, Inc CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic, LTD CurrentSince Jul 29, 2013 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Mar 1, 2020 Accepting new patients
Northern Pines Medical Center CurrentSince Jan 1, 2026 Accepting new patients
Pine Medical Center CurrentSince Oct 1, 2021 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St Marys Medical Center Past Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1154559763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "21942",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154559763",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154559763",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154559763",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LARSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.