OrganizationActive
Acne, Skin Disease & Leg Vein Clinic, P.A.
NPI 1417163189 · Dermatology Physician · Coon Rapids, MN
Provider details
- NPI number
- 1417163189
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Theodore Buselmeier, President(763) 427-8113
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 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
3960 Coon Rapids Blvd Nw
Suite 116
Coon Rapids, MN 55433-2569
Phone: (763) 427-8113
Fax: (763) 427-8131
Street-level locationGet directions
Mailing address
3960 Coon Rapids Blvd Nw
Coon Rapids, MN 55433-2569
Registry dates
- Enumerated
- 2007-05-16
- Last updated
- 2008-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.