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Active NPI 1689692758 Individual Practitioner Male Practitioner

Mark Kenneth Widstrom

Obstetrics & Gynecology • Duluth, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Mark Widstrom is a certified Obstetrics & Gynecology practicing in Duluth, MN. With approximately 33 years of clinical experience since graduating from University Of Minnesota Medical School in 1993, Mark Widstrom delivers high-quality medical care to the local community at 400 E 3RD ST.

Mark Widstrom maintains professional affiliations with The Duluth Clinic Ltd, Polinsky Medical Rehabilitation Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

400 E 3rd St

Duluth, MN 558051951

Telephone 2187868364
Associated Practice Facility / Clinic
🏢 The Duluth Clinic, Ltd Facility NPI 1245278209

Medicare Profile & Education

Medical School

University Of Minnesota Medical School

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Obstetrics & Gynecology in Duluth, MN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
33 Yrs +12.2 yrs vs City Avg
City Avg: 20.8 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
30 Specialists

Practicing in Duluth, MN (902 Statewide)

Telehealth Adoption Rate
3.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
63.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Widstrom (33 Years) 33 Yrs
Duluth Specialty Average (20.8 Years) 20.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
15 14 $166.87 $60.82

Medical Specialties & State Licenses

Obstetrics & Gynecology Primary Specialty

NUCC Taxonomy Code: 207V00000X

State License MN 45497

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
34348400 (WI)
Medicaid State Provider ID
542440200 (MN)

Hospital & Practice Group Affiliations

The Duluth Clinic Ltd

502 E 2nd St, Duluth, MN 558051913

Phone: 2187868364

The Duluth Clinic Ltd

400 E 3rd St, Duluth, MN 558051951

Phone: 2187868364

The Duluth Clinic Ltd

402 E 2nd St, Duluth, MN 558051906

Phone: 2187864000

The Duluth Clinic Ltd

530 E 2nd St, Duluth, MN 558051913

Phone: 2187868364

Polinsky Medical Rehabilitation Center

1600 Miller Trunk Hwy, Duluth, MN 558115640

Phone: 2187865360

The Duluth Clinic Ltd

420 E 1st St, Duluth, MN 558051901

Phone: 2187868364

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Molly Dwyer , APRN, CNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1003468760

Advanced Practice Registered Nurse, Certified Nurse Practitioner

NPI 1003565292

Doctor of Medicine (M.D.)

Kelsey O'neil , APRN, CNP

Nurse Practitioner - Family

NPI 1003677303

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Annette Barker

Nurse Practitioner - Family

NPI 1003845595
Bruce Derauf

Radiology - Diagnostic Radiology

NPI 1003847385
Nizar Saleh

Internal Medicine - Cardiovascular Disease

NPI 1003857889

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 09, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location May 09, 2011

Registered at 400 E 3RD ST, DULUTH, MN 558051951 (Tel: 2187868364)

📍
Updated Business Mailing Address May 09, 2011

Registered at 400 E 3RD ST, DULUTH, MN 558051951 (Tel: 2187868364)

👤
Provider Name / Credentials Updated May 09, 2011

Recorded as MARK WIDSTROM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2011

Obstetrics & Gynecology (License #45497 in MN)

🟢
Initial NPI Registration & Enumeration July 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689692758
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 17, 2006
Last Update: May 09, 2011
Sole Proprietor: No

Mailing Address

400 E 3rd St

Duluth, MN 558051951

Phone: 2187868364

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.