Paul W Sperduto, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

34957 Issued in MN

Practice address

490 S Maple St
# 117
Waconia, MN 55387-1760

Phone

(952) 442-6000

Fax

(952) 442-6004

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Mid-Minnesota Radiation Oncology, PA

  • Radiation Oncology Physician
  • Edina, MN
  • NPI 1215921408
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891789053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 FRANCE AVE S",
            "address_2": "# 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352008",
            "telephone_number": "952-920-4915",
            "fax_number": "952-915-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S MAPLE ST",
            "address_2": "# 117",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871760",
            "telephone_number": "952-442-6000",
            "fax_number": "952-442-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERDUTO",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "34957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32721200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT CHOICE",
            "identifier": "104527",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP14452",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "24-28410",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "100685",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "24-00004",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "963071000190",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "25142",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROOS/BLUE SHIELD",
            "identifier": "2M662SP",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tessa Painter Somermeyer, DNP
• Donald E. Somers, M.D.
• Lisa M Sonneman, LICSW
• Allison Joelle Sowers, PA-C
• Sally Sparby, MA, LPCC, LADC
• Murali V Srinivasan, M.D.
• Dawn M Stapleton, MD
• Rebecca Stauffer
• Barbara A. Steadman, M.D.
• Andrew Steiner, M.D.

• Radiation Oncology Physician in Waconia, MN
• Providers in Waconia, MN by specialty
• Radiation Oncology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.