Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Advanced Dermatology Care Medical Cosmetic and Surgery PA

Dermatology Physician in White Bear Lake, MN · enumerated 2006 · authorized official Olaf Rustad, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1073614558

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Registry record

Entity type Organization (Type 2)

Legal business name Advanced Dermatology Care Medical Cosmetic and Surgery PA

Other name <Unavail>

Parent organization Advanced Dermatology Care Medical and Surgical Dermatology PA

Practice address 4480 Centerville Rd, White Bear Lake, MN, 55127

Phone (651) 484-2724

Fax (651) 484-2723

Enumeration date Sep 26, 2006

Last updated in NPPES Nov 16, 2018

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Olaf Rustad

Title Owner

Phone (651) 484-2724

Other identifiers

Identifier	Type	State	Issuer
C01783	Other	MN	PTAN

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Advanced Dermatology Care Medical Cosmetic and Surgery PA?

The NPI for Advanced Dermatology Care Medical Cosmetic and Surgery PA is 1073614558, a Type 2 (organization) record in the CMS NPPES registry.

Who is the authorized official for Advanced Dermatology Care Medical Cosmetic and Surgery PA?

NPPES lists Olaf Rustad (Owner) as the authorized official for this organization.

Providers at this address

Browse all →

Shelly Larson Physician Assistant · Saint Paul, MN NPI 1982690145 Ruth Rustad Dermatology Physician · White Bear Lake, MN NPI 1689631038 Allison Nelson Physician Assistant · White Bear Lake, MN NPI 1497399901 Abigail Tracy Physician Assistant · White Bear Lake, MN NPI 1336724590 Eliza Abraham Medical Physician Assistant · White Bear Lake, MN NPI 1699437145 Brooke Elvehjem Physician Assistant · White Bear Lake, MN NPI 1174281034 Vanessa Seiberlich Physician Assistant · White Bear Lake, MN NPI 1275265514 Alaysia Freetly Physician Assistant · White Bear Lake, MN NPI 1609636182

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-11-16.