Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Mark S Mellstrom MD PA

Primary Care Clinic/Center in Lakeville, MN · enumerated 2008 · authorized official Mark Mellstrom, Owner.

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

National Provider Identifier

1629244686

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Mark S Mellstrom MD PA

Other name <Unavail>

Practice address 20157 Icenic Trail, Lakeville, MN, 55044

Phone (952) 469-3393

Fax (952) 469-3399

Enumeration date Apr 30, 2008

Last updated in NPPES Apr 30, 2008

Taxonomy & classification

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities · License 6208286 (MN) Primary

Authorized official

Name Mark Mellstrom

Title Owner

Phone (952) 469-3393

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

Where is Mark S Mellstrom MD PA located?

The practice location on file with NPPES is in Lakeville, MN.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-04-30. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-04-30.