Individual provider Active NPI

Suzanne Helene Sackett, PA-C, MHS

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1053373357
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10596 Issued in MN
Practice address
1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113
Phone
(651) 241-9700
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 10596 MN Primary

Addresses

Primary practice location

1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113

Mailing address

1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113
Phone (651) 241-9700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssackett206870@excellian.direct.allina.com Direct

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
I20111117000369 MN Practitioner - Physician Assistant 9537102512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

225 Smith Ave N
Suite 500
Saint Paul, MN 55102-2545
Phone (651) 241-2999

2925 Chicago Ave
Minneapolis, MN 55407-1321

3800 Coon Rapids Blvd NW
Suite 3800 and 3824
Coon Rapids, MN 55433-2517
Phone (612) 262-7100

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

7450 France Ave S
Suite 210
Edina, MN 55435-4784
Phone (612) 262-7100

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10596MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Apr 10, 2013 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Apr 10, 2013 Accepting new patients
Allina Health System Past Accepting new patients
Associated Neurologists, PC PastSince Jul 1, 1991 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1880 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-1800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

920 E 28th St
Ste 700
Minneapolis, MN 55407
Phone (612) 863-9062

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

225 Smith Ave N
Ste 501
Saint Paul, MN 55102
Phone (651) 241-4862

Interoperability endpoints

  • Direct secure messaging: ssackett206870@excellian.direct.allina.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1053373357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-241-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-241-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKETT",
        "first_name": "SUZANNE",
        "middle_name": "HELENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssackett206870@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1021 Bandana Blvd E",
            "address_2": "Suite 100",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551085113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.