# PEDIATRIC SURGICAL ASSOCIATES LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093778292
- **Authorized official:** MR. PAUL LOUISELLE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (612) 813-8006

## Contact information

- **Practice address:** 2530 CHICAGO AVE, SUITE 550, MINNEAPOLIS, MN 55404-4289
- **Practice address phone:** (612) 813-8000
- **Practice address fax:** (612) 813-8005
- **Mailing address:** 4530 W 77TH ST, SUITE 205, EDINA, MN 55435-5006
- **Mailing address phone:** (952) 835-9442
- **Mailing address fax:** (952) 835-9443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |
| 2088P0231X | Pediatric Urology Physician | — | NULL | — |
| 2088P0231X | Pediatric Urology Physician | — | — | — |

## Other

- **Enumeration date:** 04/10/2006
- **Last updated:** 04/08/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 360710100 | — | MN |