ESSENTIA HEALTH LAKESIDE CLINIC
NPI 1245278936
Clinic/Center - Multi-Specialty in Duluth, MN
About Essentia Health Lakeside Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ESSENTIA HEALTH LAKESIDE CLINIC (NPI 1245278936) is a healthcare organization registered as a multi-specialty in Duluth, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Kevin Boren, Vp Of Finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Essentia Health Lakeside Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
1,458Medicare enrollment records show 1,458 clinicians reassign Medicare billing to Essentia Health Lakeside Clinic, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 799 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 64
Nearest to this location (20)
See all 1,458Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 24D0403946
Essentia Health Lakeside Clinic · Duluth, MNFrequently 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 The Duluth Clinic, Ltd's NPI number?
The NPI number for The Duluth Clinic, Ltd is 1245278936. It was assigned to this organization in the NPPES registry on June 3, 2006. The provider is doing business as Essentia Health Lakeside Clinic.
Where is The Duluth Clinic, Ltd located?
The Duluth Clinic, Ltd is located at 4621 E Superior St, Duluth, MN 55804. The listed phone number is (218) 786-3550.
What is The Duluth Clinic, Ltd's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is The Duluth Clinic, Ltd enrolled in Medicare?
Yes. The Duluth Clinic, Ltd is registered in the Medicare PECOS enrollment system.
When is The Duluth Clinic, Ltd's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Minnesota, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through The Duluth Clinic, Ltd?
According to the CMS Revalidation Reassignment List (October 2026 release), 1,458 clinicians in 64 Medicare specialties reassign their Medicare billing to The Duluth Clinic, Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (252), Nurse Practitioner (246) and Family Practice (108). Of these, 10 practice at this address and 799 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does The Duluth Clinic, Ltd hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D0403946) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does The Duluth Clinic, Ltd accept?
Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Sanford Health Plan and Security Health Plan list The Duluth Clinic, Ltd 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 The Duluth Clinic, Ltd was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Essentia Health Lakeside Clinic · NPI 1245278936
Multi-Specialty organization in Duluth, Minnesota. Organization record, active in the CMS NPPES registry since June 3, 2006.
## Identity
- **NPI:** 1245278936 (Entity type: Organization)
- **Enumerated:** June 3, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Legal business name:** The Duluth Clinic, Ltd
- **Organization subpart:** Yes (part of Essentia Health)
- **Authorized official:** Kevin Boren, VP OF FINANCE
## Practice location
- **Address:** 4621 E SUPERIOR ST, Duluth, MN 55804-2338
- **Phone:** (218) 786-3550
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Minnesota, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1,458 clinicians in 64 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (252), Nurse Practitioner (246), Family Practice (108); 10 practice at this address and 799 within 10 miles; [full list](https://npiprofile.com/npi/1245278936/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2024
- **Other identifiers:** Medicaid 1245278936 (MN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1245278936) · Data from the CMS NPPES public registry.