Northland Plastic Surgery, PA

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

NORTHLAND PLASTIC SURGERY, PA

Practice address

4316 Rice Lake Rd Ste 109
Duluth, MN 55811-2885

Phone

(218) 724-7363

Fax

(218) 724-6199

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Dean Weber, MDNPI 1922036540

Title

President

Phone

(218) 724-7363

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northland Center for Plastic and Reconstructive Surgery Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23029/brand/1/csg/1/fhir/r4

Practitioners 3

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

• Dean Herbert Weber, MD

  • Plastic Surgery Physician
  • Duluth, MN
  • NPI 1922036540
  Medicare reassignment Care Compare group NPD Authorized official
• Ameya Atul Chumble, MD

  • Plastic Surgery Physician
  • Duluth, MN
  • NPI 1285126060
  Medicare reassignment Care Compare group NPD
• Thomas Jon Rishavy, MD

  • Plastic Surgery Physician
  • Duluth, MN
  • NPI 1295771798
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1275569477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 RICE LAKE RD STE 109",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112885",
            "telephone_number": "218-724-7363",
            "fax_number": "218-724-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 RICE LAKE RD STE 109",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112885",
            "telephone_number": "218-724-7363",
            "fax_number": "218-724-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND PLASTIC SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-724-7363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "952024400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northland Center for Plastic and Reconstructive Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Northland Family Physicians, LTD.
• Northland Family Programs
• Northland Gastroenterology PA
• Northland Hearing Centers, Inc.
• Northland OB-GYN Associates
• Northland Urology Asso. P.a.
• Northway Academy, Inc.
• Northwind Counseling
• Northwood Children'S Home Society Inc
• Northwood Children'S Home Society Inc

• Plastic Surgery Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Plastic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.