ST. PAUL SURGEONS LTD. NPI 1083679484

NPI Information

  • NPI: 1083679484
  • Provider Name: ST. PAUL SURGEONS, LTD.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 24D1034582
  • Address: 1655 BEAM AVE
    STE 302
    MAPLEWOOD, MN
    ZIP 55109
  • Phone: (651) 227-6351

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NPI Details

ST. PAUL SURGEONS, LTD. is a specialist in Maplewood, MN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ST. PAUL SURGEONS, LTD. NPI is 1083679484. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1655 BEAM AVE
STE 302
MAPLEWOOD, MN
ZIP 55109-163
Phone: (651) 227-6351
Fax: (651) 227-1134

The provider's authorized official is Peter H Kelly .
The authorized official title is Partner and has the following contact phone number (651) 227-6351.

The CLIA number assigned to this NPI record is 24D1034582 - other - op imaging center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 10/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist53MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C00257MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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