ST. PAUL SURGEONS, LTD.
NPI 1083679484
Specialist in Maplewood, MN

NPI Status: Active since April 19, 2006

Contact Information

1655 BEAM AVE
STE 302
MAPLEWOOD, MN
ZIP 55109
Phone: (651) 227-6351
Fax: (651) 227-1134

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  • Organization
  • Specialist
  • CLIA Number: 24D1034582
  • CLIA Cert. Type: Other - OP IMAGING CENTER
  • CLIA Exp. Date: 01-08-2026

About ST. PAUL SURGEONS, LTD.

This page provides the complete NPI Profile along with additional information for St. Paul Surgeons, Ltd., a provider established in Maplewood, Minnesota operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1083679484 assigned on April 2006. The practitioner's primary taxonomy code is 174400000X with license number 53 (MN). The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Peter H Kelly M.d. (Partner)

NPI
1083679484
Provider Name
ST. PAUL SURGEONS, LTD.
Entity Type
Organization
Location Address
1655 BEAM AVE STE 302 MAPLEWOOD, MN 55109
Location Phone
(651) 227-6351
Location Fax
(651) 227-1134
Mailing Address
1655 BEAM AVE STE 302 MAPLEWOOD, MN 55109
Mailing Phone
(651) 227-6351
Mailing Fax
(651) 227-1134
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-19-2006
Last Update Date
10-31-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
53
License State
MN
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. PETER H KELLY M.D.

Authorized Official Title
PARTNER
Authorized Official Phone
(651) 227-6351

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
C00257MEDICARE ID-TYPE UNSPECIFIED (04)MN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D1034582
Facility Type
Other - OP IMAGING CENTER
Certificate Effective Date
January 09, 2024
Certificate Expiration Date
January 08, 2026
Laboratory Director
SUSAN M. STOLTZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. Paul Surgeons, Ltd. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1083679484, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 6 → 12 → 3 9 → 18 → 9 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 6 + 3 + 1 + 2 + 7 + 1 + 8 + 4 + 1 + 6 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1083679484.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Urology
1655 BEAM AVE, SUITE 206
MAPLEWOOD, MN 55109
Obstetrics & Gynecology
1655 BEAM AVE, NUMBER 102
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Physician Assistant
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Pediatrics
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Pediatrics
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Pediatrics
1655 BEAM AVE, SUITE 202
MAPLEWOOD, MN 55109
Pediatrics
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner (Pediatrics)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Nurse Practitioner
1655 BEAM AVE, SUITE 202
MAPLEWOOD, MN 55109
Nurse Anesthetist, Certified Registered
1655 BEAM AVE
SAINT PAUL, MN 55109
Nurse Anesthetist, Certified Registered
1655 BEAM AVE
MAPLEWOOD, MN 55109

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083679484, enumerated as an "organization" on April 19, 2006.

The provider is located at 1655 BEAM AVE STE 302 MAPLEWOOD, MN 55109 and the phone number is (651) 227-6351.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.