Omni Medical Center PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

OMNI MEDICAL CENTER PLLC

Doing business as

Omni Cosmetic

Practice address

935 Wayzata Blvd E Ste 200
Wayzata, MN 55391-2513

Phone

(763) 559-4500

Fax

(763) 559-1733

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Bryan Nicholas Rolfes, MD

Title

Physician

Phone

(763) 559-4500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Omni Cosmetic Doing business as

Locations

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1659845659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 WAYZATA BLVD E STE 200",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912513",
            "telephone_number": "763-559-4500",
            "fax_number": "763-559-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 WAYZATA BLVD E STE 200",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912513",
            "telephone_number": "763-559-4500",
            "fax_number": "763-559-1733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "628 Roosevelt Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563014867",
            "country_code": "US",
            "telephone_number": "320-774-2411",
            "fax_number": "763-559-1733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OMNI MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "ROLFES",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "763-559-4500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INS",
            "identifier": "1659845659",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Cosmetic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omni Cosmetic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Vincent O'Toole, DDS
• Robert W Ogren, PSYD
• Laura N Olson
• Martha Olson, L.M.T.
• Omni Facial Plastic Surgery
• Omni Medical Center PLLC
• Steven Oppel
• Optima Mental Health and Wellness LLC
• Oral and Maxillofacial Surgical Consultants PA
• Kaisa Mahad Osman

• Plastic Surgery Physician in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Plastic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.