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DERMATOLOGY PROFESSIONALS, PA
NPI 1467169979
Dermatology - MOHS-Micrographic Surgery in Grand Rapids, MN

Active since November 03, 2022
1749 SE 2ND AVE, GRAND RAPIDS, MN 55744(218) 454-7546(218) 454-0390 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 12, 2024, Nov 3, 2022 (2 updates tracked since 2022).

About Dermatology Professionals, Pa NPPES

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

DERMATOLOGY PROFESSIONALS, PA (NPI 1467169979) is a healthcare organization registered as a mohs-micrographic surgery in Grand Rapids, Minnesota and active in the NPI registry since November 2022. The organization lists Paul Lundstrom, President, as its authorized official.

NPPES Registry Identity

NPI1467169979
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameDERMATOLOGY PROFESSIONALS, PA
Location Address1749 SE 2ND AVEGrand Rapids, MN 55744-2576
Mailing Address13359 Isle Dr Ste 3Baxter, MN 56425-2223 · (218) 454-7546 · Fax (218) 454-0390
Phone(218) 454-7546
Fax(218) 454-0390
Organization SubpartNo
Authorized OfficialPaul LundstromPresident · (218) 454-7546
Enumeration DateNovember 3, 2022
Last NPPES UpdateJune 12, 20242 updates tracked since enumeration
NPPES CertifiedJune 12, 2024
✔ NPI 1467169979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
1749 SE 2ND AVE, Grand Rapids, MN 55744
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dermatology Professionals, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Dermatology Professionals, PA, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nurse Practitioner7
Dermatology4

Clinicians, nearest first (11)

Kelley Jensen, APRN, CNP
Nurse Practitioner
NPI 1477108033
1542 GOLF COURSE RD STE 204
Grand Rapids, MN 55744
(218) 999-7000
✔ PECOS✔ Accepts Medicare1.4 mi
Katie Greniger, MSN, FNP-BC
Nurse Practitioner
NPI 1356128524
1601 GOLF COURSE RD
Grand Rapids, MN 55744
(218) 326-3401
✔ PECOS✔ Accepts Medicare1.4 mi
Angela Aakhus, M.D.
Dermatology
NPI 1326330127
1611 ANNE ST NW
Bemidji, MN 56601
(218) 333-5000
✔ PECOS✔ Accepts Medicare68 mi
Jennifer Tinkler, NP
Nurse Practitioner
NPI 1982790242
2300 24TH ST NW STE 110
Bemidji, MN 56601
(218) 444-3998
✔ PECOS✔ Accepts Medicare68 mi
Kristina Britton, M.D.
Dermatology
NPI 1982831889
1903 S 6TH ST STE 3
Brainerd, MN 56401
(218) 454-3376
✔ PECOS✔ Accepts Medicare68 mi
Paul Lundstrom, MD
Dermatology
NPI 1699759647
13359 ISLE DR SUITE 3
Baxter, MN 56425
(218) 454-7546
✔ PECOS✔ Accepts Medicare69 mi
Rebekah White, CNP
Nurse Practitioner
NPI 1598744997
13359 ISLE DR STE 3
Baxter, MN 56425
(218) 454-7546
✔ PECOS✔ Accepts Medicare69 mi
Kassandra Nelson, CNP
Nurse Practitioner
NPI 1487916532
13060 ISLE DR
Baxter, MN 56425
(218) 828-2880
✔ PECOS✔ Accepts Medicare70 mi
Sheryl Rudolf, APRN, CNP
Nurse Practitioner
NPI 1831661123
705 PLEASANT AVENUE
Park Rapids, MN 56470
(218) 732-2800
✔ PECOS✔ Accepts Medicare75 mi
Ryan Mareck, DNP
Nurse Practitioner
NPI 1508344391
130 1ST ST NE
Richmond, MN 56368
(320) 597-2122
✔ PECOS✔ Accepts Medicare130 mi
Whitney Tope, MD
Dermatology
NPI 1770506784
6545 FRANCE AVE S STE 564
Edina, MN 55435
(952) 746-6090
✔ PECOS✔ Accepts Medicare161 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Dermatology Professionals, PA's NPI number?

The NPI number for Dermatology Professionals, PA is 1467169979. It was assigned to this organization in the NPPES registry on November 3, 2022.

Where is Dermatology Professionals, PA located?

Dermatology Professionals, PA is located at 1749 SE 2nd Ave, Grand Rapids, MN 55744. The listed phone number is (218) 454-7546.

What is Dermatology Professionals, PA's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Dermatology Professionals, PA enrolled in Medicare?

Yes. Dermatology Professionals, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology Professionals, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 2 Medicare specialties reassign their Medicare billing to Dermatology Professionals, PA. 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 Nurse Practitioner (7) and Dermatology (4). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Dermatology Professionals, PA accept?

Health plans from Aspirus Health Plan, HealthPartners and Sanford Health Plan list Dermatology Professionals, PA 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 Dermatology Professionals, PA was last updated on June 12, 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.