NPIMap

Organization Active NPI

Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Lakeville, MN
National Provider Identifier
1629740949
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SUMMIT ORTHOPEDICS, LTD
Practice address
17210 Kenyon Ave
Lakeville, MN 55044-6903
Phone
(651) 968-5201
Fax
(651) 730-3553
NPI assigned
Oct 5, 2021
Last updated
Mar 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
John Bien
Title
Cfo
Phone
(651) 968-5870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

17210 Kenyon Ave
Lakeville, MN 55044-6903

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220505001003 MN DME Supplier - Multi-Specialty - Physician 8921900374 1 other NPI on this enrollment
Practice locations: Lakeville, MN

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Vadnais Heights Surgery Center LLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1629740949",
    "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",
            "fax_number": "651-968-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17210 KENYON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446903",
            "telephone_number": "651-968-5201",
            "fax_number": "651-730-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ORTHOPEDICS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "BIEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-968-5870"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.