Individual provider Active NPI

Robin Shultz, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1063968394
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2503 Issued in MN
Practice address
8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone
(952) 853-8800
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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 2503 MN Primary

Addresses

Primary practice location

8450 Seasons Pkwy
Woodbury, MN 55125-4402

Mailing address

PO Box 1309 - Mail Stop 21110Q
Minneapolis, MN 55440-1309
Phone (651) 497-5803

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
I20160909002515 MN Practitioner - Physician Assistant 8921394362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (612) 775-6200

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

6350 W 143Rd St
Savage, MN 55378-2890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2503MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Group Health, Inc. CurrentSince Aug 7, 2016 Accepting new patients
Group Health, Inc. CurrentSince Aug 7, 2016 Accepting new patients
Allina Health System CurrentSince Feb 1, 2020 Accepting new patients
Allina Health System CurrentSince Feb 1, 2020 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

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

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

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

Organizations & group practices 9

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1063968394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309 - MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "651-497-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254402",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "ROBIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.