Mark Kenneth Widstrom, - Medicare Obstetrics/gynecology in Duluth, MN

Mark Kenneth Widstrom, is a medicare enrolled "Obstetrics & Gynecology" physician in Duluth, Minnesota. He went to University Of Minnesota Medical School and graduated in 1993 and has 31 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice The Duluth Clinic Ltd and his current practice location is 400 E 3rd St, Duluth, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 786-8364.

Mark Kenneth Widstrom is licensed to practice in Minnesota (license number 45497) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1689692758.

Contact Information

Mark Kenneth Widstrom,
400 E 3rd St,
Duluth, MN 55805-1951
(218) 786-8364
Not Available

Map and Direction




Physician's Profile

Full NameMark Kenneth Widstrom
GenderMale
SpecialityObstetrics/gynecology
Experience31 Years
Location400 E 3rd St, Duluth, Minnesota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mark Kenneth Widstrom attended and graduated from University Of Minnesota Medical School in 1993
  NPI Data:
  • NPI Number: 1689692758
  • Provider Enumeration Date: 07/17/2006
  • Last Update Date: 05/09/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 4789578865
  • Enrollment ID: I20040210000684

Medical Identifiers

Medical identifiers for Mark Kenneth Widstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689692758NPI-NPPES
34348400MedicaidWI
542440200MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 45497 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Essentia Health DuluthDuluth, MNHospital
Essentia Health St Mary's Medical CenterDuluth, MNHospital
Deer River Healthcare CenterDeer river, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The Duluth Clinic Ltd2567374283932

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mark Kenneth Widstrom allows following entities to bill medicare on his behalf.
Entity NameThe Duluth Clinic Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902563638
PECOS PAC ID: 2567374283
Enrollment ID: O20031103000229
Entity NameDeer River Healthcare Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225049018
PECOS PAC ID: 1850388448
Enrollment ID: O20040427000428
Entity NameEssentia Health Virginia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083617120
PECOS PAC ID: 7810149002
Enrollment ID: O20130306000467
Entity NameEssentia Health Moose Lake
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1154959880
PECOS PAC ID: 6608290333
Enrollment ID: O20200728000758
Entity NameEssentia Health Moose Lake
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154959880
PECOS PAC ID: 6608290333
Enrollment ID: O20200730001548

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark Kenneth Widstrom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mark Kenneth Widstrom,
400 E 3rd St,
Duluth, MN 55805-1951

Ph: (218) 786-8364
Mark Kenneth Widstrom,
400 E 3rd St,
Duluth, MN 55805-1951

Ph: (218) 786-8364

Reviews and Comments


Obstetrics & Gynecology Doctors in Duluth, MN

Kirsten Ma Indrelie, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 400 E 3rd St, Duluth, MN 55805
Phone: 218-786-8364    Fax: 504-988-1846
Dr. Andrea R Lays, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 420 E 1st St, Duluth, MN 55805
Phone: 218-786-8364    
Scott William Johnson,
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 400 E 3rd St, Duluth, MN 55805
Phone: 218-786-8364    
Haley Marie Meyer, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 400 E 3rd St, Duluth, MN 55805
Phone: 218-786-8364    
Aimee Nelson Van Straaten, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 1000 E 1st St, Lower Level, Duluth, MN 55805
Phone: 218-722-5148    
Kelly Jo Greenleaf,
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 400 E 3rd St, Duluth, MN 55805
Phone: 218-786-3800    
William Gary Turner,
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 400 E 3rd St, Duluth, MN 55805
Phone: 218-786-8364    

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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