Mark S Mellstrom, MD, PA
NPI 1639340409 · Family Medicine Physician · Lakeville, MN
Mark S Mellstrom, MD, PA is a Family Medicine Physician organization in Lakeville, MN (NPI 1639340409).
Provider details
- NPI number
- 1639340409
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Mellstrom, President(952) 469-3393
- License
- 27926 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
Registry dates
- Enumerated
- 2008-03-19
- Last updated
- 2008-04-23
Frequently asked questions
- What is Mark S Mellstrom, MD, PA's NPI number?
- Mark S Mellstrom, MD, PA's National Provider Identifier (NPI) is 1639340409, 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 Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Mark S Mellstrom, MD, PA located?
- Mark S Mellstrom, MD, PA's practice location on file with NPPES is 20157 Icenic Trl, Lakeville, MN 55044-7708.
- 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, President. 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 (1639340409) is active in the NPPES registry as of the last update on 2008-04-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.