OrganizationActive
Advanced Dermatology Care Medical Cosmetic and Surgery PA
NPI 1912158031 · Dermatology Physician · Forest Lake, MN
Provider details
- NPI number
- 1912158031
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Olaf Rustad, Dermatologist(651) 484-2724
- License
- 1376 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 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
25 Lake St N
Suite 200
Forest Lake, MN 55025-2535
Phone: (651) 484-2724
Street-level locationGet directions
Mailing address
4480 Centerville Rd
Saint Paul, MN 55127-3674
Other names (DBA / former)
- Doing business as
- Advanced Dermatology Care
Registry dates
- Enumerated
- 2008-10-07
- Last updated
- 2010-01-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.