Organization Active NPI

Western Orthopaedic & Sports Medicine Consultants, P.a.

  • Specialist
  • Waconia, MN
National Provider Identifier
1548225402
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1464 Issued in MN
Legal business name
WESTERN ORTHOPAEDIC & SPORTS MEDICINE CONSULTANTS, P.A.
Practice address
490 S Maple St
Waconia, MN 55387-1760
Phone
(952) 442-6525
Fax
(952) 442-6526
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. D Daniel Rotenberg, M.D.
Title
Partner
Phone
(952) 442-6525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 1464 MN Primary

Addresses

Primary practice location

490 S Maple St
Waconia, MN 55387-1760

Mailing address

7261 Ohms LN
Edina, MN 55439-2148
Phone (952) 442-6525

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548225402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392148",
            "telephone_number": "952-442-6525",
            "fax_number": "952-442-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871760",
            "telephone_number": "952-442-6525",
            "fax_number": "952-442-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN ORTHOPAEDIC & SPORTS MEDICINE CONSULTANTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTENBERG",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "952-442-6525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "1464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.