Individual provider Active NPI

Mark Labelle, MD

  • Orthopaedic Surgery Physician
  • Eagan, MN
National Provider Identifier
1275923971
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
11709309-1205 Issued in UT
Practice address
2620 Eagan Woods Dr
Eagan, MN 55121-1138
Phone
(651) 968-5201
NPI assigned
Feb 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 70082 MN
Orthopaedic Surgery Physician 207X00000X 70082 MN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 11709309-1205 UT
Orthopaedic Surgery Physician 207X00000X 11709309-1205 UT Primary

Addresses

Primary practice location

2620 Eagan Woods Dr
Eagan, MN 55121-1138

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MLABELLE439986@DIRECT.MED.UTAH.EDU Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200612000056 UT Practitioner - Orthopedic Surgery 7214231612 Reassigns benefits to 2 organizations
I20210908002843 MN Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 7214231612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Northwestern University Feinberg Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 968-5201

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Brooklyn Park, MN, CCN 247145
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11709309-1205UTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services Current Accepting new patients
Summit Orthopedics LTD Orthopaedic Surgery CurrentSince Sep 7, 2021 Accepting new patients
University of Utah Adult Services CurrentSince May 8, 2020 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince May 8, 2020 Accepting new patients
University of Utah Pediatric Services CurrentSince May 8, 2020 Accepting new patients
Summit Orthopedics LTD Current Accepting new patients
Summit Orthopedics, LTD Orthopaedic Surgery CurrentSince Sep 7, 2021 Accepting new patients
Ilbnc, P.a. Past Accepting new patients

Locations

10230 Baltimore St NE
#300
Blaine, MN 55449
Phone (651) 968-5300

15450 Highway 7
Ste 125
Minnetonka, MN 55345
Phone (763) 581-8950

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

Interoperability endpoints

  • Direct secure messaging: mlabelle439986@direct.med.utah.edu
  • Direct secure messaging: marklabelle@sol.allscriptsdirect.net

Organizations & group practices 9

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 5

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": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275923971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABELLE",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "70082",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "70082",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "11709309-1205",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "11709309-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MLABELLE439986@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.