Individual provider Active NPI

Scott Randall Pepin, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Woodbury, MN
National Provider Identifier
1841429453
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
109016 Issued in MN
Practice address
2090 Woodwinds Dr Ste 100
Woodbury, MN 55125-2522
Phone
(651) 968-5201
Fax
(651) 968-5201
NPI assigned
Jul 6, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01073563A IN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 109016 MN Primary

Addresses

Primary practice location

2090 Woodwinds Dr Ste 100
Woodbury, MN 55125-2522

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160726003013 MN Practitioner - Orthopedic Surgery 8325284516 Reassigns benefits to 1 organization
I20210622002170 WI Practitioner - Orthopedic Surgery 8325284516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 968-5201

319 S Main St
River Falls, WI 54022-2452
Phone (651) 968-5201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109016MNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD Orthopaedic Surgery CurrentSince Sep 1, 2016 Accepting new patients
Summit Orthopedics LTD Orthopaedic Surgery CurrentSince Sep 1, 2016 Accepting new patients
Summit Orthopedics LTD Current Accepting new patients
Ilbnc, P.a. Past Accepting new patients
Summit Orthopedics, LTD. Past Accepting new patients

Locations

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5335

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 271-1592

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5770

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5600

2090 Woodwinds Dr
Ste 100
Woodbury, MN 55125
Phone (651) 968-5600

2090 Woodwinds Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5600

4123 Radio Dr
Woodbury, MN 55129
Phone (651) 968-5300

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

319 S Main St
River Falls, WI 54022
Phone (715) 425-6701

Interoperability endpoints

  • Direct secure messaging: scottpepin@sol.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841429453",
    "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": "651-968-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPIN",
        "first_name": "SCOTT",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01073563A",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "109016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.