NPIMap

Individual provider Active NPI

Marcus John Mittelsteadt, M.D.

  • Orthopaedic Surgery Physician
  • Fridley, MN
National Provider Identifier
1215347117
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
67925 Issued in MN
Practice address
8290 University Ave NE Ste 200
Fridley, MN 55432-1876
Phone
(763) 786-9543
Fax
(763) 786-3320
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301116868 MI
Orthopaedic Surgery Physician 207X00000X 67925 MN Primary

Addresses

Primary practice location

8290 University Ave NE Ste 200
Fridley, MN 55432-1876

Mailing address

8290 University Ave NE Ste 200
Fridley, MN 55432-1876
Phone (763) 786-9543

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
I20200819002566 MN Practitioner - Orthopedic Surgery 5092019810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Creighton University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

11225 Ulysses St NE
Blaine, MN 55434-4261
Phone (763) 302-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67925MNMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota Current Accepting new patients
Infinite Health Collaborative, PA Orthopaedic Surgery CurrentSince Sep 8, 2020 Accepting new patients
Sanford Health of Northern Minnesota Orthopaedic Surgery CurrentSince Dec 4, 2020 Accepting new patients
Infinite Health Collaborative, PA Orthopaedic Surgery CurrentSince Sep 8, 2020 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600

3111 124th Ave NW
Ste 200
Coon Rapids, MN 55433
Phone (763) 427-7300

8290 University Ave NE
Ste 200
Fridley, MN 55432
Phone (763) 786-9543

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

2450 Riverside Ave
#Sr200
Minneapolis, MN 55454
Phone (612) 273-1177

16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707

Organizations & group practices 6

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.

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1215347117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321876",
            "telephone_number": "763-786-9543",
            "fax_number": "763-786-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321876",
            "telephone_number": "763-786-9543",
            "fax_number": "763-786-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELSTEADT",
        "first_name": "MARCUS",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301116868",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "67925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.