Organization Active NPI

Plastic Surgery Center of Duluth PLLC

  • Plastic Surgery Physician
  • Duluth, MN
National Provider Identifier
1558988477
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY CENTER OF DULUTH PLLC
Practice address
324 W Superior St Ste 100
Duluth, MN 55802-1763
Phone
(218) 215-8990
Fax
(218) 217-4371
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Dr. Edgar F Saldana, MDNPI 1043260557
Title
MD/Owner
Phone
(218) 215-8990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

324 W Superior St Ste 100
Duluth, MN 55802-1763

Mailing address

324 W Superior St Ste 100
Duluth, MN 55802-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200917000587 MN Part B Supplier - Clinic/Group Practice 8426476821 Receives reassigned benefits from 1 practitioner
Practice locations: Duluth, MN

National Provider Directory

National Provider Directory

Locations

324 W Superior St
Ste 100
Duluth, MN 55802
Phone (218) 215-8990

324 W Superior St
Ste 330
Duluth, MN 55802

7831 E Bush Lake Rd
Ste 302
Minneapolis, MN 55439

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": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1558988477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 100",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 100",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021763",
            "telephone_number": "218-215-8990",
            "fax_number": "218-217-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CENTER OF DULUTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "SALDANA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "218-215-8990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.