William Frederic Northrup III, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20586 Issued in MN

Practice address

4770 White Bear Pkwy
Lower Level
White Bear Lake, MN 55110-3394

Phone

(651) 653-1850

Fax

(651) 426-6439

NPI assigned

Apr 14, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bryan Medical Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lincoln, NE
  • NPI 1629157789
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265496343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 LAKEVIEW DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554241520",
            "telephone_number": "925-926-6913",
            "fax_number": "651-426-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 WHITE BEAR PKWY",
            "address_2": "LOWER LEVEL",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103394",
            "telephone_number": "651-653-1850",
            "fax_number": "651-426-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "WILLIAM",
        "middle_name": "FREDERIC",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "20586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "108709",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "109263",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "536K0NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "A57110010519",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "18-00157",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "202741675 55110 A001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.