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NORTHERN LAKES SURGERY CENTER LLC
NPI 1649922485
Clinic/Center - Ambulatory Surgical in Moose Lake, MN

Active since January 24, 2022CLIA 24D2264643 · Waiver
4791 COUNTY ROAD 10, MOOSE LAKE, MN 55767(218) 249-5357 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 11, 2026, Dec 19, 2024, Jan 31, 2023 and 1 more (4 updates tracked since 2022).

About Northern Lakes Surgery Center Llc NPPES

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

NORTHERN LAKES SURGERY CENTER LLC (NPI 1649922485) is a healthcare organization registered as an ambulatory surgical in Moose Lake, Minnesota and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through July 17, 2028 and lists Lori Peck, Svp- Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1649922485
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameNORTHERN LAKES SURGERY CENTER LLC
Location Address4791 COUNTY ROAD 10Moose Lake, MN 55767-9221
Mailing Address915 E 1st StDuluth, MN 55805-2107
Phone(218) 249-5357
Organization SubpartNo
Authorized OfficialLori PeckSvp- Chief Financial Officer · (715) 847-2575
Enumeration DateJanuary 24, 2022
Last NPPES UpdateMarch 11, 20264 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1649922485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
4791 COUNTY ROAD 10, Moose Lake, MN 55767
Open in Google Maps ↗

Other Names 1

Doing Business AsNorthern Lakes Surgery Center Llc

Accepted Insurance

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

Northern Lakes Surgery Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Northern Lakes Surgery Center LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Steve Tekippe, M.D.
Family Practice
NPI 1194728733
4570 CTY. HWY. 61
Moose Lake, MN 55767
(218) 485-4491
✔ PECOS✔ Accepts Medicare0.9 mi
James Mach
Certified Registered Nurse Anesthetist (CRNA)
NPI 1245758234
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-4481
✔ PECOS✔ Accepts Medicare29 mi
Erin Laveau-Allen, APRN, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1588203061
400 E 3RD ST
Duluth, MN 55805
(218) 786-8364
✔ PECOS✔ Accepts Medicare40 mi
Dustin Lucarelli, MD
General Surgery
NPI 1003170424
920 E 1ST ST STE P302
Duluth, MN 55805
(218) 262-4881
✔ PECOS✔ Accepts Medicare41 mi
Mariya Skube, M.D.
General Surgery
NPI 1235573643
920 E 1ST ST STE P302
Duluth, MN 55805
(218) 249-5555
✔ PECOS✔ Accepts Medicare41 mi
David Fogarty, M.D.
Orthopedic Surgery
NPI 1508823410
1012 E 2ND ST
Duluth, MN 55805
(218) 249-6360
✔ PECOS✔ Accepts Medicare41 mi
Michael Momont, M.D.
Orthopedic Surgery
NPI 1417952912
1000 E 1ST ST STE 400
Duluth, MN 55805
(218) 722-5513
✔ PECOS✔ Accepts Medicare41 mi
Aimee Vanstraaten, MD
Obstetrics/Gynecology
NPI 1093895062
1000 E 1ST ST LOWER LEVEL
Duluth, MN 55805
(218) 722-5148
✔ PECOS✔ Accepts Medicare41 mi
Rebekah Beach, MD
Urology
NPI 1487941993
1001 E SUPERIOR ST SUITE L201
Duluth, MN 55802
(218) 249-7980
✔ PECOS✔ Accepts Medicare41 mi

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

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 24D2264643

Northern Lakes Surgery Center LLC · Moose Lake, MN
Active · expires Jul 17, 2028
CLIA Number24D2264643
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 18, 2026
Certificate Expiration DateJuly 17, 2028
Laboratory DirectorJennifer Alaspa
Laboratory Phone(218) 249-5357
Laboratory LocationNorthern Lakes Surgery Center LLC4791 County Road 10 Ste 101, Moose Lake, MN 55767
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

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.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
38 services38 patients
Injection of substance into lower spine canal using imaging guidance 62323
This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
38 services22 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
32 services20 patients
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260
This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.
29 services14 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
22 services22 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
20 services11 patients

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 Northern Lakes Surgery Center LLC's NPI number?

The NPI number for Northern Lakes Surgery Center LLC is 1649922485. It was assigned to this organization in the NPPES registry on January 24, 2022.

Where is Northern Lakes Surgery Center LLC located?

Northern Lakes Surgery Center LLC is located at 4791 County Road 10, Moose Lake, MN 55767. The listed phone number is (218) 249-5357.

What is Northern Lakes Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Northern Lakes Surgery Center LLC enrolled in Medicare?

Yes. Northern Lakes Surgery Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northern Lakes Surgery Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians reassign their Medicare billing to Northern Lakes Surgery Center LLC, in Certified Registered Nurse Anesthetist (CRNA), Family Practice, General Surgery, Obstetrics/Gynecology, Orthopedic Surgery and 1 other specialty. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Northern Lakes Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2264643) is associated with this NPI, valid through July 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northern Lakes Surgery Center LLC accept?

Health plans from Aspirus Health Plan, HealthPartners and Security Health Plan list Northern Lakes Surgery Center LLC 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 Northern Lakes Surgery Center LLC was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.