NORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE
NPI 1912069519
Pediatrics - Adolescent Medicine in Vadnais Heights, MN
NPI Status: Active since December 14, 2006
Contact Information
3555 WILLOW LAKE BLVD.
SUITE 140
VADNAIS HEIGHTS, MN
ZIP 55110
Phone: (651) 251-5280
Fax: (651) 251-5282
- Organization
- Pediatrics
- Adolescent Medicine
- Accepts Insurance
- CLIA Number: 24D0399415
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-22-2027
About NORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE
This page provides the complete NPI Profile along with additional information for Northern Lights Pediatric & Adolescent Medicine, a pediatrician established in Vadnais Heights, Minnesota operating as a Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1912069519 assigned on December 2006. The practitioner's primary taxonomy code is 2080A0000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Wendy Marian Nelms Mccabe M.d. (Partner)
- NPI
- 1912069519
- Provider Name
- NORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE
- Entity Type
- Organization
- Location Address
- 3555 WILLOW LAKE BLVD. SUITE 140 VADNAIS HEIGHTS, MN 55110
- Location Phone
- (651) 251-5280
- Location Fax
- (651) 251-5282
- Mailing Address
- 3555 WILLOW LAKE BLVD. SUITE 140 VADNAIS HEIGHTS, MN 55110
- Mailing Phone
- (651) 251-5280
- Mailing Fax
- (651) 251-5282
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-14-2006
- Last Update Date
- 05-20-2009
- Code Navigator
A pediatrician like Northern Lights Pediatric & Adolescent Medicine is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
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
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 29960NO | OTHER (01) | MN | BCBS MN |
| 744432000 | MEDICAID (05) | MN | |
| 165339 | OTHER (01) | MN | UCARE |
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
- 24D0399415
- Facility Type
- Physician Office
- Certificate Effective Date
- December 23, 2025
- Certificate Expiration Date
- December 22, 2027
- Laboratory Director
- DR. WENDY M. MCCABE
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Northern Lights Pediatric & Adolescent Medicine on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high 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 1912069519, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
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 61 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912069519, enumerated as an "organization" on December 14, 2006.
The provider is located at 3555 WILLOW LAKE BLVD. SUITE 140 VADNAIS HEIGHTS, MN 55110 and the phone number is (651) 251-5280.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: HealthPartners, Medica, Blue Cross Blue Shield,. Please consult your insurance carrier or call the provider to verify.
