Mara Suzanne Edison, DO
Individual provider Active NPI Family Medicine Physician · Hermantown, MN
NPI 1154718484 · NPPES record last updated Aug 11, 2021
Key facts
- NPI
- 1154718484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 64087 (MN)
- Practice address
- 4855 W Arrowhead Rd
Hermantown, MN 55811-3936 - Phone
- (218) 786-3540
- NPI assigned
- Apr 24, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Polinsky Medical Rehabilitation Center
The Duluth Clinic LTD
Practice addresses (Care Compare)
1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540
Hospital & facility affiliations
- Benedictine Home Health Duluth
- Ecumen Home Care Lakeshore
- Aveanna Home Health
- Essentia Health Duluth
- Essentia Health St Mary'S Medical Center
- St Marys Hospital Superior
- Essentia Health Virginia
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180806003360 | MN | Practitioner - Family Practice | 6204108087 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 64087 | MN | Yes |
Addresses
Primary practice location
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | maraedison@uhps.allscriptsdirect.net |
Other providers in Hermantown, MN
- Sarah Marie Ebmer
- Brooke Marie Eddy
- Edgewood Hermantown 1 Senior Living LLC
- Edgewood Hermantown I Senior Living LLC
- Edgewood Hermantown II Senior Living LLC
- Jaden Ellefson
- Lucas Michael Elsner
- Cassie Endsley
- Dixie Engebretsen
- Christie Ehle Erickson IX
All providers in Hermantown, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.