Individual provider Active NPI

Paul Allen Cederberg, MD

  • Orthopaedic Surgery Physician
  • St Louis Park, MN
National Provider Identifier
1336187772
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24260 Issued in MN
Practice address
6490 Excelsior Boulevard
Suite W417 Meadowbrook Medical Building
St Louis Park, MN 55426-4705
Phone
(952) 925-2388
Fax
(952) 925-0743
NPI assigned
Jun 4, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 24260 MN Primary

Addresses

Primary practice location

6490 Excelsior Boulevard
Suite W417 Meadowbrook Medical Building
St Louis Park, MN 55426-4705

Mailing address

6490 Excelsior Boulevard
Suite W417 Meadowbrook Medical Building
St Louis Park, MN 55426-4705
Phone (952) 925-2388

Other identifiers 3

IdentifierTypeStateIssuer
0925946OtherMNMEDICA
3D613CEOtherMNBLUE CROSS BLUE SHIELD
924850118001OtherPREFERRED ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 3, 2019 through Dec 3, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24260MNMDOrthopaedic Surgery Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336187772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6490 EXCELSIOR BOULEVARD",
            "address_2": "SUITE W417 MEADOWBROOK MEDICAL BUILDING",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264705",
            "telephone_number": "952-925-2388",
            "fax_number": "952-924-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 EXCELSIOR BOULEVARD",
            "address_2": "SUITE W417 MEADOWBROOK MEDICAL BUILDING",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264705",
            "telephone_number": "952-925-2388",
            "fax_number": "952-925-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDERBERG",
        "first_name": "PAUL",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "24260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0925946",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3D613CE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "924850118001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.