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MEDPARK SPECIALIZED SURGERY, LLC
NPI 1184375545
Clinic/Center - Ambulatory Surgical in Fargo, ND

Active since January 17, 2022CLIA 35D2253048 · Waiver
4450 31ST AVE S STE 201, FARGO, ND 58104(701) 293-9829 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 24, 2023, Feb 8, 2022, Jan 17, 2022 (3 updates tracked since 2022).

About Medpark Specialized Surgery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDPARK SPECIALIZED SURGERY, LLC (NPI 1184375545) is a healthcare organization registered as an ambulatory surgical in Fargo, North Dakota and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through February 15, 2028 and lists Leslie Heitkamp, Director, as its authorized official.

NPPES Registry Identity

NPI1184375545
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMEDPARK SPECIALIZED SURGERY, LLC
Location Address4450 31ST AVE S STE 201Fargo, ND 58104-4556
Mailing Address4450 31st Ave S Ste 201Fargo, ND 58104-4598 · (701) 951-2020
Phone(701) 293-9829
Organization SubpartNo
Authorized OfficialLeslie HeitkampDirector · (701) 951-2022
Enumeration DateJanuary 17, 2022
Last NPPES UpdateMarch 24, 20233 updates tracked since enumeration
NPPES CertifiedMarch 24, 2023
✔ NPI 1184375545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
4450 31ST AVE S STE 201, Fargo, ND 58104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 35D2253048

Medpark Specialized Surgery · Fargo, ND
Active · expires Feb 15, 2028
CLIA Number35D2253048
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 16, 2026
Certificate Expiration DateFebruary 15, 2028
Laboratory DirectorLeslie Heitkamp
Laboratory Phone(701) 951-2020
Laboratory LocationMedpark Specialized Surgery4450 31st Ave S Suite 201, Fargo, ND 58104
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of membrane of retina with removal of internal limiting membrane of retina 67042
This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.
54 services54 patients
Removal of eye fluid (vitreous) between lens and retina 67036
This procedure, known as a vitrectomy, involves removing some or all of the vitreous humor, the clear gel-like substance in the eye. It's done to treat various eye conditions, like retinal detachment or macular hole. The aim is to improve or stabilize vision. It's performed under local or general anesthesia.
32 services29 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIGHT NIGHT ANESTHESIA, PLLC
Nurse Anesthetist, Certified Registered
4450 31ST AVE S STE 201
FARGO, ND 58104
Cass County (701) 293-9829

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medpark Specialized Surgery, LLC's NPI number?

The NPI number for Medpark Specialized Surgery, LLC is 1184375545. It was assigned to this organization in the NPPES registry on January 17, 2022.

Where is Medpark Specialized Surgery, LLC located?

Medpark Specialized Surgery, LLC is located at 4450 31st Ave S Ste 201, Fargo, ND 58104. The listed phone number is (701) 293-9829.

What is Medpark Specialized Surgery, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Medpark Specialized Surgery, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2253048) is associated with this NPI, valid through February 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Medpark Specialized Surgery, LLC accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Medpark Specialized Surgery, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Medpark Specialized Surgery, LLC was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.