NPIMap

Individual provider Active NPI

David R Vavra, MD

  • Surgery Physician
  • Brainerd, MN
National Provider Identifier
1154813210
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
76927 Issued in MN
Practice address
2024 S 6TH St
Brainerd, MN 56401-4529
Phone
(218) 828-7100
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 72074 WI
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 76927 MN Primary

Addresses

Primary practice location

2024 S 6TH St
Brainerd, MN 56401-4529

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8000

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
I20240821001911 MN Practitioner - General Surgery 1052744570 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy46
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux38
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72074WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Health Services, Inc. CurrentSince May 21, 2024 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Aug 26, 2024 Accepting new patients
St. Joseph'S Health Services, Inc. CurrentSince May 21, 2024 Accepting new patients
St. Joseph'S Medical Center CurrentSince Aug 26, 2024 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 31, 2023 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Nov 20, 2024 Accepting new patients
St. Joseph'S Health Services, Inc. Current Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jul 31, 2023 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St Joseph'S Medical Center CurrentSince Aug 26, 2024 Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients
Brainerd Medical Center Inc CurrentSince Aug 26, 2024 Accepting new patients
The Duluth Clinic, LTD CurrentSince Nov 20, 2024 Accepting new patients
Brainerd Medical Center Inc Past Accepting new patients
St. Joseph'S Medical Center Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

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

280 Barclay Ave W
Pine River, MN 56474
Phone (218) 587-3222

301 2nd Ave NW
Staples, MN 56479
Phone (218) 894-7870

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

Interoperability endpoints

  • Direct secure messaging: dvavra786226@direct.gundersenhealth.org

Organizations & group practices 16

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

View all 16

Hospital & facility affiliations 10

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1154813210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-828-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRA",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "72074",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "76927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.