Individual provider Active NPI

Dawn M Stapleton, MD

  • Surgery Physician
  • Waconia, MN
National Provider Identifier
1811068935
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
EC-05-055 Issued in ME
Practice address
424 W State Highway 5
Waconia, MN 55387-1723
Phone
(952) 442-4461
Fax
(952) 442-5753
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X EC-05-055 ME Primary

Addresses

Primary practice location

424 W State Highway 5
Waconia, MN 55387-1723

Mailing address

424 W State Highway 5
Waconia, MN 55387-1723
Phone (952) 442-4461

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
I20101026000380 MN Practitioner - General Surgery 1355534074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Clinic, LTD.Group PAC ID 6002801453, 52 clinicians

Practice addresses (Care Compare)

424 W Hwy 5
Waconia, MN 55387-1723

424 W State Hwy 5
Waconia, MN 55387-1723
Phone (952) 442-4461

Hospital & facility affiliations

  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion19
Colonoscopy44
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EC-05-055MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Clinic, LTD. CurrentSince Aug 31, 2010 Accepting new patients

Locations

110105 Pioneer Trl W
Chaska, MN 55318
Phone (952) 361-5800

406 Faxon Rd N
Nya, MN 55368
Phone (952) 467-1915

424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461

313 Territorial St E
Watertown, MN 55388
Phone (952) 442-4461

Interoperability endpoints

  • Direct secure messaging: dawnstapleton@tv.allscriptsdirect.net

Organizations & group practices 1

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 2

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": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1811068935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871723",
            "telephone_number": "952-442-4461",
            "fax_number": "952-442-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871723",
            "telephone_number": "952-442-4461",
            "fax_number": "952-442-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "DAWN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "EC-05-055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.