NPIMap

Individual provider Active NPI

Dakota James Lundstrom, MD

  • Family Medicine Physician
  • Hermantown, MN
National Provider Identifier
1871179812
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80616 Issued in MN
Practice address
4190 Loberg Ave
Hermantown, MN 55811-2652
Phone
(218) 249-4600
NPI assigned
Mar 21, 2021
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 80616 MN Primary

Addresses

Primary practice location

4190 Loberg Ave
Hermantown, MN 55811-2652

Mailing address

4190 Loberg Ave
Hermantown, MN 55811-2652
Phone (218) 249-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251001002819 MN Practitioner - Family Practice 7719380641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota, Duluth School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80616MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Sep 1, 2025 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Sep 1, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

4190 Loberg Ave
Hermantown, MN 55811
Phone (218) 249-4600

Interoperability endpoints

  • Direct secure messaging: dlundstrom438511@direct.aspirus.org

Organizations & group practices 3

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1871179812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTROM",
        "first_name": "DAKOTA",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "80616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.