Northwest Iowa Surgeons - Spencer – Surgery Physician, NPI 1710560180

Northwest Iowa Surgeons - Spencer is a healthcare provider. based in Waconia, Minnesota. specializing in Surgery Physician. The NPI Number for Northwest Iowa Surgeons - Spencer is 1710560180

Main info

Organization
Name
Northwest Iowa Surgeons - Spencer
NPI
1710560180
Phone
(888) 278-4126
Address
400 10TH ST E
Authorized Official
BRENDA TIEFENTHALER PRESIDENT/CEO
Enumeration Date
3 May 2021
Last Update Date
10 October 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness80
Years active:5State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Northwest Iowa Surgeons - Spencer

  • 400 10TH ST E

    WACONIA, MN 553874552

    Phone: (888) 278-4126

    Type: Mailing

  • 1823 HIGHWAY BLVD STE 5

    SPENCER, IA 513012226

    Phone: (712) 262-6320

    Fax: (712) 264-3007

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-02-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20220218000692OClinic/Group PracticeIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55387)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does Northwest Iowa Surgeons - Spencer share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Northwest Iowa Surgeons - Spencer uses 1710560180.
Does the file indicate Northwest Iowa Surgeons - Spencer is practicing under active NPI?
Directory data currently reports Northwest Iowa Surgeons - Spencer as active.
What taxonomy line describes Northwest Iowa Surgeons - Spencer?
For research purposes, treat Northwest Iowa Surgeons - Spencer as Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Northwest Iowa Surgeons - Spencer list a practice location?
Patients near Waconia, Minnesota may find Northwest Iowa Surgeons - Spencer in results; validate coverage separately.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

900 2nd Ave
NPI: 1255338067
1200 1st Ave E
NPI: 1295713261
East 10th Street, Interlaken West, Waconia, Carver County, Minnesota, 55387, United States of America
NPI: 1912930660

TODD D ELFTMANN (M.D.)

Surgery Physician
State Highway 5, Waconia, Carver County, Minnesota, 55387, United States
NPI: 1689751943

KEVIN A TAYLOR (M.D.)

Surgery Physician
State Highway 5, Waconia, Carver County, Minnesota, 55387, United States
NPI: 1598844136

DR. DAWN M STAPLETON (MD)

Surgery Physician
State Highway 5, Waconia, Carver County, Minnesota, 55387, United States
NPI: 1811068935

DR. BORIANA I PETKOV (MD)

Surgery Physician
State Highway 5, Waconia, Carver County, Minnesota, 55387, United States
NPI: 1942378872

JAYANT V BELSARE (MD)

Surgery Physician
400 E 10TH ST
NPI: 1326165028
424 W HIGHWAY 5
NPI: 1063611770