Individual provider Active NPI

Peter Robert Letourneau, MD

  • Plastic Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1699899609
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
61308 Issued in MN
Practice address
401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(651) 254-8290
Fax
(651) 254-8299
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 61308 MN Primary

Addresses

Primary practice location

401 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

8170 33Rd Ave S
Ms: 21110Q
Bloomington, MN 55425-4516

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161006000161 MN Practitioner - Plastic and Reconstructive Surgery 0840488623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Rochester School of Medicine and Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61308MNMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jan 15, 2017 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jan 15, 2017 Accepting new patients
Group Health, Inc. CurrentSince Oct 3, 2016 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

Interoperability endpoints

  • Direct secure messaging: pletourneau218609@direct.healthpartners.com

Organizations & group practices 5

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1699899609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS: 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-8290",
            "fax_number": "651-254-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETOURNEAU",
        "first_name": "PETER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "61308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.