SOUTHDALE PEDIATRIC ASSOCIATES, LTD
NPI 1245305895
Clinic/Center - Multi-Specialty in Edina, MN
About Southdale Pediatric Associates, Ltd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHDALE PEDIATRIC ASSOCIATES, LTD (NPI 1245305895) is a healthcare organization registered as a multi-specialty in Edina, Minnesota and active in the NPI registry since November 2006. The organization holds 3 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Saira Mitha, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southdale Pediatric Associates, Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Southdale Pediatric Associates, Ltd, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: 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 3
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 Accreditation 24D0680782
Southdale Pediatric Associates · Eden Prairie, MNCertificate of Accreditation 24D0680781
Southdale Pediatric Associates · Burnsville, MNCertificate of Accreditation 24D0403224
Southdale Pediatric Associates · Edina, 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 Southdale Pediatric Associates, Ltd's NPI number?
The NPI number for Southdale Pediatric Associates, Ltd is 1245305895. It was assigned to this organization in the NPPES registry on November 21, 2006.
Where is Southdale Pediatric Associates, Ltd located?
Southdale Pediatric Associates, Ltd is located at 6600 France Ave S Ste 300, Edina, MN 55435. The listed phone number is (952) 278-7000.
What is Southdale Pediatric Associates, Ltd's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Southdale Pediatric Associates, Ltd enrolled in Medicare?
Yes. Southdale Pediatric Associates, Ltd is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southdale Pediatric Associates, Ltd?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Southdale Pediatric Associates, 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 Allergy/Immunology (3) and Pediatric Medicine (3). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southdale Pediatric Associates, Ltd hold CLIA laboratory certificates?
Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Southdale Pediatric Associates, Ltd was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.