OrganizationActive
Independent Professionals PC
NPI 1710133566 · Anesthesiology Physician · Wayzata, MN
Provider details
- NPI number
- 1710133566
- Entity type
- Organization
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Lane, President(952) 401-6200
- License
- 42949 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
319 Barry Ave S
Suite 300
Wayzata, MN 55391-1658
Phone: (952) 473-1111
Street-level locationGet directions
Mailing address
50 Interlachen Ln
Excelsior, MN 55331-9469
Registry dates
- Enumerated
- 2008-08-12
- Last updated
- 2008-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.