Individual provider Active NPI

Sandra Ogato, PA-C

  • Physician Assistant
  • Lakeville, MN
National Provider Identifier
1023526506
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12676 Issued in MN
Practice address
18275 Kenrick Ave
Lakeville, MN 55044-7306
Phone
(866) 389-2727
NPI assigned
Jan 18, 2018
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12676 MN Primary

Addresses

Primary practice location

18275 Kenrick Ave
Lakeville, MN 55044-7306

Mailing address

19131 Harappa Ave
Lakeville, MN 55044-4776

Other identifiers 1

IdentifierTypeStateIssuer
1023526506MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180515001090 MN Practitioner - Physician Assistant 6608130901 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 528-6999

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

18580 Joplin Ave
Lakeville, MN 55044-4218
Phone (952) 892-9555

1875 Woodwinds Dr
Woodbury, MN 55125-2298
Phone (651) 232-6800

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

303 E Nicollet Blvd
Burnsville, MN 55337-4588
Phone (952) 460-4000

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 881-2651

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6545 France Ave S
Suite 150
Edina, MN 55435-2180
Phone (952) 848-5600

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Oct 5, 2022 Accepting new patients
Fairview Clinics CurrentSince Oct 5, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 5, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 5, 2022 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

3305 Central Park Village Dr
#130
Saint Paul, MN 55121

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: sogato366820@fairview.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1023526506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19131 HARAPPA AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447306",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGATO",
        "first_name": "SANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023526506",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.