NPIMap

Organization Active NPI

Minnesota Orthopaedic Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Fridley, MN
National Provider Identifier
1972553741
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
HFID#04305 Issued in MN
Legal business name
MINNESOTA ORTHOPAEDIC SURGERY CENTER, LLC
Practice address
8290 University Ave NE
Suite 100
Fridley, MN 55432-1847
Phone
(763) 786-0461
Fax
(763) 786-0471
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Dr. Peter D Holmberg, M.D.NPI 1972521748
Title
President
Phone
(763) 786-9543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X HFID#04305 MN Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

8290 University Ave NE
Suite 100
Fridley, MN 55432-1847

Mailing address

8290 University Ave NE
Suite 100
Fridley, MN 55432-1847
Phone (763) 717-4105

Other identifiers 1

IdentifierTypeStateIssuer
726170500MedicaidMN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1972553741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE",
            "address_2": "SUITE 100",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321847",
            "telephone_number": "763-717-4105",
            "fax_number": "952-456-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVE NE",
            "address_2": "SUITE 100",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321847",
            "telephone_number": "763-786-0461",
            "fax_number": "763-786-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA ORTHOPAEDIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-786-9543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MN",
            "license": "HFID#04305",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "726170500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.