DERMATOLOGY PROFESSIONALS PA
NPI 1306196548
Clinic/Center in Baxter, MN
NPI Status: Active since September 14, 2012
Contact Information
15167 EDGEWOOD DR
SUITE 200
BAXTER, MN
ZIP 56401
Phone: (218) 454-7546
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 24D2047643
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-11-2026
About DERMATOLOGY PROFESSIONALS PA
This page provides the complete NPI Profile along with additional information for Dermatology Professionals Pa, a provider established in Baxter, Minnesota operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1306196548 assigned on September 2012. The practitioner's primary taxonomy code is 261Q00000X with license number 45453 (MN). The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Morgan Burgstaler (Administrator)
- NPI
- 1306196548
- Provider Name
- DERMATOLOGY PROFESSIONALS PA
- Entity Type
- Organization
- Location Address
- 15167 EDGEWOOD DR SUITE 200 BAXTER, MN 56401
- Location Phone
- (218) 454-7546
- Mailing Address
- 13359 ISLE DR SUITE 3 BAXTER, MN 56425
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-14-2012
- Last Update Date
- 06-12-2024
- Code Navigator
Location Map
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
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 45453
- License State
- MN
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Bronze HSA - EPO
- Essentia Choice Care with Medica Bronze Share - EPO
- Essentia Choice Care with Medica Bronze Share - HMO
- Essentia Choice Care with Medica Expanded Bronze Standard - EPO
- Essentia Choice Care with Medica Expanded Bronze Standard - HMO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Gold Share - EPO
- Essentia Choice Care with Medica Gold Share - HMO
- Essentia Choice Care with Medica Gold Standard - EPO
- Essentia Choice Care with Medica Gold Standard - HMO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Silver Share - EPO
- Essentia Choice Care with Medica Silver Share - HMO
- Essentia Choice Care with Medica Silver Standard - EPO
- Essentia Choice Care with Medica Silver Standard - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 24D2047643
- Facility Type
- Physician Office
- Certificate Effective Date
- September 12, 2024
- Certificate Expiration Date
- September 11, 2026
- Laboratory Director
- PAUL B. LUNDSTROM
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Dermatology Professionals Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1306196548, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306196548, enumerated as an "organization" on September 14, 2012.
The provider is located at 15167 EDGEWOOD DR SUITE 200 BAXTER, MN 56401 and the phone number is (218) 454-7546.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Medica. Please consult your insurance carrier or call the provider to verify.
