Active NPI 1396060281 Individual Practitioner Male Practitioner

Dr. Peter Hawley Rogers , DO

Internal Medicine • Rogers, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Peter Rogers, DO is a certified Internal Medicine practicing in Rogers, MN. With approximately 16 years of clinical experience since completing medical education in 2010, Dr. Rogers delivers high-quality medical care to the local community at 13688 ROGERS DR.

Dr. Rogers maintains professional affiliations with Lakeview Clinic, Ltd., Ridgeview Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include insertion of needle into vein for collection of blood sample, established patient outpatient office visit, complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

13688 Rogers Dr

Rogers, MN 553744916

Telephone 9529770300

Medicare Profile & Education

Medical School

Other

Graduation Year

2010

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Rogers, MN

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs +1.0 yrs vs City Avg

City Avg: 15.0 Yrs

State Avg: 23.6 Yrs

Regional Practice Density

4 Specialists

Practicing in Rogers, MN (2726 Statewide)

Telehealth Adoption Rate

25.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Rogers (16 Years) 16 Yrs

Rogers Specialty Average (15.0 Years) 15.0 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
36415 Insertion of needle into vein for collection of blood sample	163	107	$15.00	$8.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	151	96	$365.00	$124.37
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	106	83	$40.00	$7.61
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	98	86	$27.00	$7.87
80053 Blood test, comprehensive group of blood chemicals	85	76	$50.00	$10.35
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	65	42	$498.31	$173.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	64	30	$261.00	$75.71
84443 Blood test, thyroid stimulating hormone (TSH)	64	59	$50.00	$16.46
80061 Blood test, lipids (cholesterol and triglycerides)	62	58	$50.00	$13.12
83036 Hemoglobin A1C level	51	47	$40.00	$9.52
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	42	42	$370.00	$126.01
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	41	39	$572.00	$167.61
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	37	16	$171.89	$60.69
99213 Established patient office or other outpatient visit, typically 15 minutes	36	33	$275.00	$88.35
80048 Blood test, basic group of blood chemicals (calcium, total)	33	25	$40.00	$8.29
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	29	14	$393.00	$113.64
G0444 Annual depression screening, 5 to 15 minutes	25	25	$26.00	$18.70
99239 Hospital discharge day management, more than 30 minutes	25	25	$378.00	$111.13
G0103 Prostate cancer screening; prostate specific antigen test (psa)	17	17	$95.00	$18.92
G0008 Administration of influenza virus vaccine	14	14	$33.00	$31.34
84153 Psa (prostate specific antigen) measurement, total	13	11	$95.00	$18.02
81001 Manual urinalysis test with examination using microscope, automated	13	11	$25.00	$3.11
90653 Vaccine for influenza for injection into muscle	13	13	$107.00	$81.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	373	318	$26.00	$7.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	161	106	$365.12	$126.62
36415 Insertion of needle into vein for collection of blood sample	136	100	$15.00	$8.40
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	128	55	$220.00	$76.53
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	95	79	$40.00	$7.61
80053 Blood test, comprehensive group of blood chemicals	89	79	$50.00	$10.35
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	62	62	$613.00	$167.83
80061 Blood test, lipids (cholesterol and triglycerides)	61	60	$50.00	$13.12
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	51	51	$370.00	$128.92
99213 Established patient office or other outpatient visit, typically 15 minutes	49	40	$270.51	$89.50
84443 Blood test, thyroid stimulating hormone (TSH)	48	47	$50.00	$16.46
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	36	23	$483.61	$175.74
99239 Hospital discharge day management, more than 30 minutes	35	34	$325.00	$111.07
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	34	18	$317.00	$115.11
83036 Hemoglobin A1C level	27	25	$40.00	$9.52
G0103 Prostate cancer screening; prostate specific antigen test (psa)	24	24	$95.00	$18.92
G0008 Administration of influenza virus vaccine	21	21	$33.00	$29.91
80048 Blood test, basic group of blood chemicals (calcium, total)	19	16	$40.00	$8.29
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	18	18	$75.00	$73.50
81001 Manual urinalysis test with examination using microscope, automated	17	16	$25.00	$3.11
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$418.00	$122.01
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$490.00	$163.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$321.25	$110.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	416	297	$25.00	$8.01
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	163	80	$218.00	$68.67
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	147	92	$359.42	$127.19
36415 Insertion of needle into vein for collection of blood sample	134	102	$15.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	123	99	$253.78	$89.79
80053 Blood test, comprehensive group of blood chemicals	83	72	$50.00	$10.41
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	82	77	$40.61	$7.57
80061 Blood test, lipids (cholesterol and triglycerides)	56	52	$50.54	$13.20
84443 Blood test, thyroid stimulating hormone (TSH)	53	50	$50.91	$16.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	42	42	$368.21	$130.89
G0103 Prostate cancer screening; prostate specific antigen test (psa)	30	30	$95.00	$19.06
99239 Hospital discharge day management, more than 30 minutes	28	28	$323.00	$101.88
G0008 Administration of influenza virus vaccine	25	25	$33.00	$29.31
90662 Influenza vaccine split virus, preservative free	24	24	$69.17	$65.72
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	24	24	$413.00	$129.39
81001 Manual urinalysis test with examination using microscope, automated	24	19	$25.00	$3.13
80048 Blood test, basic group of blood chemicals (calcium, total)	23	19	$40.00	$7.99
93000 Routine ekg using at least 12 leads including interpretation and report	20	20	$80.00	$13.49
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$608.00	$189.86
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	15	11	$314.00	$98.61
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	12	$479.64	$177.11
99225 Subsequent observation care, typically 25 minutes per day	11	11	$218.00	$68.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	185	107	$15.00	$2.97
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	179	91	$216.00	$69.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	143	96	$324.16	$128.62
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	112	69	$50.00	$7.82
85610 Blood test, clotting time	102	14	$30.00	$4.29
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	90	67	$25.00	$8.18
99213 Established patient office or other outpatient visit, typically 15 minutes	87	74	$224.77	$91.34
80053 Blood test, comprehensive group of blood chemicals	75	63	$50.00	$10.40
80048 Blood test, basic group of blood chemicals (calcium, total)	65	28	$40.00	$8.46
80061 Blood test, lipids (cholesterol and triglycerides)	58	55	$60.00	$13.45
84443 Blood test, thyroid stimulating hormone (TSH)	56	54	$66.00	$16.55
0012A Adm sarscov2 100mcg/0.5ml2nd	47	47	$50.00	$34.41
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	44	44	$344.77	$132.75
0011A Adm sarscov2 100mcg/0.5ml1st	43	43	$50.00	$21.82
0002A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; second dose	25	25	$50.00	$40.01
G0103 Prostate cancer screening; prostate specific antigen test (psa)	24	24	$95.00	$19.31
0001A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose	23	23	$50.00	$18.01
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	22	$412.00	$131.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$319.50	$111.74
91301 Sarscov2 vac 100mcg/0.5ml im	18	18	$0.01	$0.01
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	17	12	$312.00	$100.49
0004A Fee covid-19 vac 1 res	17	17	$50.00	$40.01
G0008 Administration of influenza virus vaccine	16	16	$33.00	$17.01
99239 Hospital discharge day management, more than 30 minutes	16	16	$320.00	$103.95
81001 Manual urinalysis test with examination using microscope, automated	16	15	$25.00	$3.17
93000 Routine ekg using at least 12 leads including interpretation and report	15	14	$80.00	$14.76
90662 Influenza vaccine split virus, preservative free	15	15	$63.33	$63.33
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	12	12	$605.00	$194.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	186	127	$213.95	$75.26
36415 Insertion of needle into vein for collection of blood sample	127	93	$15.00	$2.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	112	55	$214.54	$72.28
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	95	87	$32.00	$8.51
85610 Blood test, clotting time	94	14	$30.00	$4.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	74	55	$314.32	$109.31
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	57	48	$50.00	$7.74
80053 Blood test, comprehensive group of blood chemicals	57	56	$50.00	$10.50
80061 Blood test, lipids (cholesterol and triglycerides)	48	46	$60.00	$13.33
84443 Blood test, thyroid stimulating hormone (TSH)	44	41	$66.00	$16.72
80048 Blood test, basic group of blood chemicals (calcium, total)	37	33	$40.00	$8.43
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	32	32	$338.75	$117.43
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	26	$401.62	$135.56
G0103 Prostate cancer screening; prostate specific antigen test (psa)	25	25	$94.40	$19.26
99239 Hospital discharge day management, more than 30 minutes	23	23	$310.57	$106.81
G0008 Administration of influenza virus vaccine	20	20	$33.00	$16.82
81001 Manual urinalysis test with examination using microscope, automated	19	19	$25.00	$3.16
90662 Influenza vaccine split virus, preservative free	17	17	$60.00	$60.00
93000 Routine ekg using at least 12 leads including interpretation and report	16	15	$80.00	$17.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	202	132	$199.50	$73.78
36415 Insertion of needle into vein for collection of blood sample	172	110	$15.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	162	92	$289.38	$107.89
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	119	54	$235.03	$70.86
85610 Blood test, clotting time	100	14	$30.00	$4.28
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	63	44	$50.00	$8.46
80053 Blood test, comprehensive group of blood chemicals	62	53	$50.00	$11.51
80048 Blood test, basic group of blood chemicals (calcium, total)	53	40	$42.00	$9.21
84443 Blood test, thyroid stimulating hormone (TSH)	47	45	$66.00	$18.30
80061 Blood test, lipids (cholesterol and triglycerides)	43	42	$60.00	$14.58
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	34	34	$320.00	$116.38
81001 Manual urinalysis test with examination using microscope, automated	27	22	$30.00	$3.45
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	27	12	$342.00	$101.87
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	24	$433.84	$132.91
G0008 Administration of influenza virus vaccine	22	22	$33.00	$16.48
99239 Hospital discharge day management, more than 30 minutes	22	22	$352.00	$103.28
G0103 Prostate cancer screening; prostate specific antigen test (psa)	21	21	$92.00	$20.03
93000 Routine ekg using at least 12 leads including interpretation and report	20	19	$80.00	$16.46
90662 Influenza vaccine split virus, preservative free	20	20	$55.00	$53.90
87088 Bacterial urine culture	19	14	$40.00	$8.81
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$205.00	$76.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$291.88	$107.16
71046 X-ray of chest, 2 views	15	13	$88.00	$31.83
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	13	11	$31.00	$8.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	164	98	$15.65	$2.90
99213 Established patient office or other outpatient visit, typically 15 minutes	145	103	$175.55	$72.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	111	79	$256.44	$106.23
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	82	48	$47.35	$9.40
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	82	43	$229.06	$69.59
80053 Blood test, comprehensive group of blood chemicals	56	47	$47.46	$12.55
80048 Blood test, basic group of blood chemicals (calcium, total)	41	32	$42.00	$9.98
80061 Blood test, lipids (cholesterol and triglycerides)	37	36	$57.74	$16.20
84443 Blood test, thyroid stimulating hormone (TSH)	28	26	$62.92	$20.33
81001 Manual urinalysis test with examination using microscope, automated	23	19	$28.88	$3.84
G0103 Prostate cancer screening; prostate specific antigen test (psa)	21	21	$88.81	$22.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$270.00	$105.45
87088 Bacterial urine culture	19	15	$38.48	$9.79
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	19	19	$282.41	$115.10
99239 Hospital discharge day management, more than 30 minutes	19	18	$338.84	$99.91
93000 Routine ekg using at least 12 leads including interpretation and report	18	18	$80.00	$16.67
G0008 Administration of influenza virus vaccine	17	16	$31.69	$20.39
90662 Influenza vaccine split virus, preservative free	16	15	$46.59	$45.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$438.00	$132.75
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$174.91	$74.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	139	69	$223.00	$70.27
99213 Established patient office or other outpatient visit, typically 15 minutes	129	90	$75.29	$70.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	64	$111.15	$104.45
36415 Insertion of needle into vein for collection of blood sample	81	60	$5.10	$2.93
85610 Blood test, clotting time	44	12	$5.37	$5.26
80053 Blood test, comprehensive group of blood chemicals	37	33	$16.33	$13.01
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	31	24	$28.00	$8.29
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	30	20	$18.45	$10.22
81001 Manual urinalysis test with examination using microscope, automated	22	18	$6.65	$4.23
99239 Hospital discharge day management, more than 30 minutes	21	21	$332.00	$105.14
G0008 Administration of influenza virus vaccine	19	19	$25.56	$25.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$126.71	$105.02
90662 Influenza vaccine split virus, preservative free	16	16	$31.82	$31.18
87088 Bacterial urine culture	16	13	$14.67	$10.84
84443 Blood test, thyroid stimulating hormone (TSH)	16	16	$28.31	$21.56
80061 Blood test, lipids (cholesterol and triglycerides)	16	16	$18.27	$13.87
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$74.02	$72.99
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$425.00	$132.38
80048 Blood test, basic group of blood chemicals (calcium, total)	13	11	$13.88	$10.39
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$315.00	$97.36
93000 Routine ekg using at least 12 leads including interpretation and report	12	12	$22.17	$16.07

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MN 57882

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License MN 57882

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Hospital & Practice Group Affiliations

Ridgeview Medical Center

7907 Powers Blvd, Chanhassen, MN 553179502

Phone: 9529340570

Ridgeview Medical Center

500 S Maple St, Waconia, MN 553871752

Phone: 9524422191

Lakeview Clinic, Ltd.

424 W State Hwy 5, Waconia, MN 553871723

Phone: 9524424461

Practice Associates & Co-Workers

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

9 Associated Practitioners

Angela Rickheim

Nurse Practitioner

NPI 1023568763

Dr. Kathryn Aune , MD

Internal Medicine

NPI 1043503352

Doctor of Medicine (M.D.)

Jaime Miller , NP

Nurse Practitioner

NPI 1215829577

Nurse Practitioner

Dr. Daniel Albright , MD

Pediatrics

NPI 1295710192

Doctor of Medicine (M.D.)

Dr. Courtney Plemel , MD

Pediatrics

NPI 1316508161

Doctor of Medicine (M.D.)

Dr. Alexandra Wells , MD

Internal Medicine

NPI 1326313420

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active August 17, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location August 17, 2015

Registered at 13688 ROGERS DR, ROGERS, MN 553744916 (Tel: 9529770300)

📍

Updated Business Mailing Address August 17, 2015

Registered at 14401 WESTRIDGE DR, EDEN PRAIRIE, MN 553471700 (Tel: 6125994952)

👤

Provider Name / Credentials Updated August 17, 2015

Recorded as PETER ROGERS, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 17, 2015

Internal Medicine (License #57882 in MN)

🟢

Initial NPI Registration & Enumeration April 02, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1396060281

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 02, 2010

Last Update: August 17, 2015

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

14401 Westridge Dr

Eden Prairie, MN 553471700

Phone: 6125994952

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

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