Southdale Physicians, LLC
NPI 1124569249 · Internal Medicine Physician · Edina, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southdale Physicians, LLC is a Internal Medicine Physician organization in Edina, MN (NPI 1124569249).
Provider details
- NPI number
- 1124569249
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Derek Dagendesh, Office Administrator(952) 999-4049
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
Mailing address
Registry dates
- Enumerated
- 2017-03-09
- Last updated
- 2025-02-17
- Certified
- 2025-02-17
Frequently asked questions
- What is Southdale Physicians, LLC's NPI number?
- Southdale Physicians, LLC's National Provider Identifier (NPI) is 1124569249, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southdale Physicians, LLC?
- Southdale Physicians, LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southdale Physicians, LLC located?
- Southdale Physicians, LLC's practice location on file with NPPES is 6565 France Ave S Ste 350, Edina, MN 55435-2137.
- What is Southdale Physicians, LLC's phone number?
- The practice phone number listed in the NPPES registry for Southdale Physicians, LLC is (612) 430-8120.
- Does Southdale Physicians, LLC accept Medicare?
- Southdale Physicians, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southdale Physicians, LLC?
- The authorized official listed on Southdale Physicians, LLC's NPPES record is Derek Dagendesh, Office Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southdale Physicians, LLC's NPI active?
- Yes — Southdale Physicians, LLC's NPI (1124569249) is active in the NPPES registry as of the last update on 2025-02-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.