OrganizationActive
Diabetic Shoe Source
NPI 1003960147 · Durable Medical Equipment & Medical Supplies · Eagan, MN
Provider details
- NPI number
- 1003960147
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Amy Luzaich, President(763) 757-8086
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2121 Cliff Dr Ste 118
Eagan, MN 55122-3431
Phone: (763) 757-8086
Fax: (763) 862-4797
Street-level locationGet directions
Mailing address
2121 Cliff Dr Ste 118
Eagan, MN 55122-3431
Registry dates
- Enumerated
- 2007-01-23
- Last updated
- 2021-10-21
- Certified
- 2021-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.