Minnesota Orthopaedic Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MINNESOTA ORTHOPAEDIC SURGERY CENTER LLC

Practice address

8290 University Ave NE
Suite 100
Fridley, MN 55432-1847

Phone

(763) 786-0461

Fax

(763) 786-0471

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Peter D Holmberg, M.D.

Title

President

Phone

(763) 786-9543

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1548219397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE",
            "address_2": "SUITE 100",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321847",
            "telephone_number": "763-786-0461",
            "fax_number": "763-786-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE",
            "address_2": "SUITE 100",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321847",
            "telephone_number": "763-786-0461",
            "fax_number": "763-786-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA ORTHOPAEDIC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-786-9543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "7Y16MI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1021808",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "726170500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mind Therapy Center LLC
• Mindful Way Counseling, LLC
• Minneapolis-St. Paul Periodontics
• Minnesota Chiroworks, PLLC
• Minnesota Oncology Hematology, PA
• Minnesota Orthopaedic Surgery Center, LLC
• Laura Ellen Mitchell
• Marcus John Mittelsteadt, M.D.
• Zadiq Omar Moallim
• Rachael Moberg, PA-C

• Ambulatory Surgical Clinic/Center in Fridley, MN
• Providers in Fridley, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.