DR. LUKE DAVID WIDSTROM D.O.
NPI 1366886053
Family Medicine - Sports Medicine in Duluth, MN

Q: What is Luke Widstrom's NPI number?

The NPI number for Luke Widstrom is 1366886053. It was assigned to this individual provider in the NPPES registry on April 24, 2013.

Q: What is Luke Widstrom's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Luke Widstrom was last updated on May 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since April 24, 2013PECOS EnrolledAccepts Medicare Assignment

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805(218) 786-8364 Get Directions Write a Review

NPPES record last updated: May 3, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 3, 2018, Dec 27, 2017, Aug 19, 2016 (3 updates tracked since 2016).

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About Dr. Luke David Widstrom D.o. NPPES

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

DR. LUKE DAVID WIDSTROM D.O. (NPI 1366886053) is an individual sports medicine provider in Duluth, Minnesota, licensed in Minnesota (58494) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Mary's Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1366886053

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameDR. LUKE DAVID WIDSTROMCredential: D.O.

Location Address400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINICDuluth, MN 55805-1951

Mailing Address400 East Third Street, Essentia Health Duluth Clinic Mcl2credDuluth, MN 55805-1951 · (218) 786-8364

Phone(218) 786-8364

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 24, 2013

Last NPPES UpdateMay 3, 20183 updates tracked since enumeration

✔ NPI 1366886053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in MN · 58494

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License TL.0006261 (CO)

400 EAST THIRD STREET, Duluth, MN 55805

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Luke David Widstrom D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648490185

PECOS Enrollment IDI20141003000768

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

186 services31 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

160 services77 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

117 services94 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

89 services68 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

72 services72 patients

Aspiration and/or injection of fluid from large joint 20610

66 services32 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

33 services29 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

30 services30 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

25 services21 patients

Aspiration and/or injection of fluid from small joint 20600

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

25 services16 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

18 services13 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

16 services11 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

15 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Essentia Health St Mary's Medical Center

Acute Care Hospitals · Duluth, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240002

Location402 East Second StreetDuluth, MN 55805 · St. Louis County

Emergency services Birthing friendly

Essentia Health Duluth

Acute Care Hospitals · Duluth, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240019

Location502 East Second StreetDuluth, MN 55805 · St. Louis County

Birthing friendly

Essentia Health Moose Lake

Critical Access Hospitals · Moose Lake, MN

OwnershipGovernment - Hospital District or Authority

CMS Certification Number241350

Location4572 County Road 61Moose Lake, MN 55767 · Carlton County

Emergency services Birthing friendly

Essentia Health Deer River

Critical Access Hospitals · Deer River, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241360

Location115 10th Avenue NortheastDeer River, MN 56636 · Itasca County

Emergency services

St Marys Hospital Superior

Critical Access Hospitals · Superior, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521329

Location3500 Tower AveSuperior, WI 54880 · Douglas County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. TIMOTHY E BORDEN D.O.

Emergency Medicine (Hospice and Palliative Medicine)

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

MICHELE MARIE DAVIS APRN, CNP

Nurse Practitioner (Adult Health)

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

MARIA KATARZYNA BEAVER MD

Pathology (Anatomic Pathology & Clinical Pathology)

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

DR. HILARY CLAIRE REICH M.D.

Dermatology

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULTUH, MN 55805

St. Louis County (218) 786-8364

MALLORIE MARIE VAN WINKLE DPT

Physical Therapist

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-5360

SARAH KATHERINE DAGGETT CPNP

Nurse Practitioner (Pediatrics)

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

DR. NISAR ZAIDI MD

Surgery

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

DR. ERIN KATHLEEN RUST MD

Hospitalist

400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC
DULUTH, MN 55805

St. Louis County (218) 786-8364

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 Luke Widstrom's NPI number?

The NPI number for Luke Widstrom is 1366886053. It was assigned to this individual provider in the NPPES registry on April 24, 2013.

Where is Luke Widstrom located?

Luke Widstrom practices at 400 East Third Street Essentia Health Duluth Clinic, Duluth, MN 55805. The listed phone number is (218) 786-8364.

What is Luke Widstrom's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Luke Widstrom enrolled in Medicare?

Yes. Luke Widstrom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Luke Widstrom accept?

Health plans from HealthPartners, Medica, Sanford Health Plan and Security Health Plan list Luke Widstrom 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.

Is Luke Widstrom affiliated with any hospitals?

According to CMS data, Luke Widstrom is affiliated with Essentia Health St Mary's Medical Center, Essentia Health Duluth, Essentia Health Moose Lake, Essentia Health Deer River and St Marys Hospital Superior.

When was this NPI record last updated?

The NPPES record for Luke Widstrom was last updated on May 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.