Individual provider Active NPI

Paige Peplinski

  • Physician Assistant
  • Eagan, MN
National Provider Identifier
1053291740
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4349 Jessica CT
Eagan, MN 55123-2611
Phone
(651) 724-4427
NPI assigned
Sep 4, 2025
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 Primary

Addresses

Primary practice location

4349 Jessica CT
Eagan, MN 55123-2611

Mailing address

4349 Jessica CT
Eagan, MN 55123-2611

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
I20260122000859 MN Practitioner - Physician Assistant 6002393972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4349 Jessica CT
Eagan, MN 55123-2611

5939 Portland Ave
Minneapolis, MN 55417-3127

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diamond Lake Clinic, P.C. CurrentSince Dec 14, 2025 Accepting new patients

Locations

5939 Portland Ave
Minneapolis, MN 55417
Phone (612) 866-6100

Organizations & group practices 1

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": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1053291740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4349 JESSICA CT",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4349 JESSICA CT",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232611",
            "telephone_number": "651-724-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPLINSKI",
        "first_name": "PAIGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.