Paul Lundstrom, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

45453 Issued in MN

Practice address

13359 Isle Dr
Suite 3
Baxter, MN 56425-2222

Phone

(218) 454-7546

NPI assigned

Dec 2, 2005

Last updated

Jun 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of North Dakota School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Professionals, PAGroup PAC ID 4587753934, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.53 of 100Reported as group

Quality

100

Promoting interoperability

99

Improvement activities

40

Cost

95.93

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology Professionals, PA

  • Clinic/Center
  • Baxter, MN
  • NPI 1720269426
  Medicare reassignment Care Compare group Authorized official
• Dermatology Professionals, PA

  • MOHS-Micrographic Surgery Physician
  • Grand Rapids, MN
  • NPI 1467169979
  NPD (past) Authorized official
• Dermatology Professionals PA

  • Clinic/Center
  • Baxter, MN
  • NPI 1306196548
  NPD
• Dermatology Professionals PA

  • Clinic/Center
  • Saint Cloud, MN
  • NPI 1720840788
  NPD
• Dermatology Professionals, PA

  • Clinic/Center
  • Bemidji, MN
  • NPI 1356714182
  NPD (past)

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1699759647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13359 ISLE DR",
            "address_2": "SUITE 3",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564252222",
            "telephone_number": "218-454-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13359 ISLE DR",
            "address_2": "SUITE 3",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564252222",
            "telephone_number": "218-454-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTROM",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "45453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "741720900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal J Longseth
• Longville Lakes Clinic, Inc. (Cuyuna Regional Medical Center)
• Alicia Fiona Lund
• Joshua Lundquist
• Hannah Lundstrom
• Caleb Michael Lunning, DDS
• LVH PA (Lakeland Veterinary Hospital)
• Brooklyn Lyons
• Nadia Maddaus
• James D Madison, MD

• Dermatology Physician in Baxter, MN
• Providers in Baxter, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.