OrganizationActive
Family Surgery Center, LLC
NPI 1962583369 · Anesthesiology Physician · Willmar, MN
Provider details
- NPI number
- 1962583369
- Entity type
- Organization
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carmen Macik, Administrator(320) 214-5759
- License
- 330845 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 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
1801 19th Ave Sw
Willmar, MN 56201-4946
Phone: (320) 235-7700
Fax: (320) 235-7701
Street-level locationGet directions
Mailing address
1801 19th Ave Sw
Willmar, MN 56201-4946
Registry dates
- Enumerated
- 2006-10-18
- Last updated
- 2012-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.