NPIMap

Organization Active NPI

Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
National Provider Identifier
1760614242
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SUMMIT ORTHOPEDICS, LTD
Practice address
2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone
(651) 968-5801
Fax
(651) 968-5899
NPI assigned
Aug 17, 2009
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Surgery of the Hand (Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0105X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X
Magnetic Resonance Imaging Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471M1202X

Addresses

Primary practice location

2090 Woodwinds Dr
Woodbury, MN 55125-2522

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930085714 MN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8921900374 Practice locations: Woodbury, 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2093260Summit Orthopedics LTD2090 Woodwinds Drive Suite 250, Woodbury, MN 55125Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summit Orthopedics LTD32 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": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1760614242",
    "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": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5801",
            "fax_number": "651-968-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ORTHOPEDICS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.