Mark S Mellstrom MD PA
NPI 1629244686 · Primary Care Clinic/Center · Lakeville, MN
Mark S Mellstrom MD PA is a Primary Care Clinic/Center organization in Lakeville, MN (NPI 1629244686).
Provider details
- NPI number
- 1629244686
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Mellstrom, Owner(952) 469-3393
- License
- 6208286 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Other names (DBA / former)
- Doing business as
- Lakeville Family Practice
Registry dates
- Enumerated
- 2008-04-30
- Last updated
- 2008-04-30
Frequently asked questions
- What is Mark S Mellstrom MD PA's NPI number?
- Mark S Mellstrom MD PA's National Provider Identifier (NPI) is 1629244686, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mark S Mellstrom MD PA?
- Mark S Mellstrom MD PA is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Mark S Mellstrom MD PA located?
- Mark S Mellstrom MD PA's practice location on file with NPPES is 20157 Icenic Trail, Lakeville, MN 55044.
- What is Mark S Mellstrom MD PA's phone number?
- The practice phone number listed in the NPPES registry for Mark S Mellstrom MD PA is (952) 469-3393.
- Who is the authorized official for Mark S Mellstrom MD PA?
- The authorized official listed on Mark S Mellstrom MD PA's NPPES record is Mark Mellstrom, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mark S Mellstrom MD PA's NPI active?
- Yes — Mark S Mellstrom MD PA's NPI (1629244686) is active in the NPPES registry as of the last update on 2008-04-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.