Organization Active NPI

Wayzata Orthopedic'S P.a.

  • Orthopaedic Surgery Physician
  • Plymouth, MN
National Provider Identifier
1164428223
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22452 Issued in MN
Legal business name
WAYZATA ORTHOPEDIC'S P.A.
Practice address
2805 Campus Dr
Ste 425
Plymouth, MN 55441-2680
Phone
(763) 383-0770
Fax
(763) 383-0777
NPI assigned
Jun 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Mr. Thomas F. Varecka, M.D.
Title
President
Phone
(763) 383-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 22452 MN Primary

Addresses

Primary practice location

2805 Campus Dr
Ste 425
Plymouth, MN 55441-2680

Mailing address

2805 Campus Drive
Ste 425
Plymouth, MN 55441-2616
Phone (763) 383-0770

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1164428223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 CAMPUS DRIVE",
            "address_2": "STE 425",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412616",
            "telephone_number": "763-383-0770",
            "fax_number": "763-383-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 CAMPUS DR",
            "address_2": "STE 425",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412680",
            "telephone_number": "763-383-0770",
            "fax_number": "763-383-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYZATA ORTHOPEDIC'S P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "VARECKA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-383-0770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "22452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.