Elizabeth Bachorik, NP
Individual provider Active NPI Nurse Practitioner · Minneapolis, MN
NPI 1083870646 · NPPES record last updated Mar 19, 2019
Key facts
- NPI
- 1083870646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R 203612-4 (MN)
- Practice address
- 7801 E Bush Lake Rd Ste 400
Minneapolis, MN 55439 - Phone
- (952) 283-3162
- Fax
- (866) 991-7241
- NPI assigned
- Aug 4, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Regenerative Medical Management
Practice addresses (Care Compare)
7818 Excelsior Rd
Baxter, MN 56425-8427
Phone (218) 450-4045
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111031000375 | MN | Practitioner - Nurse Practitioner | 3971660820 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 203612-4 | MN | MD | Nurse Practitioner |
| 002467916 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Regenerative Medical Management | Nurse Practitioner | Current |
Accepting new patients |
| LTC Professionals, PLLC | Current |
Accepting new patients | |
| Brainerd Lakes Wellness, PC | Past |
Accepting new patients |
Locations
7818 Excelsior Rd
Ste 200
Baxter, MN 56425
Phone (218) 270-9922
7818 Excelsior Rd
Baxter, MN 56425
Phone (218) 450-4045
7818 Excelsior Rd
Ste 100
Baxter, MN 56425
Phone (218) 454-9355
7801 E Bush Lake Rd
Ste 400
Minneapolis, MN 55439
Phone (952) 283-3162
1010 Dale St N
Saint Paul, MN 55117
Phone (612) 482-6610
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 002467916 | VA | |
| Adult Health Nurse Practitioner | 363LA2200X | 792 | MN | |
| Nurse Practitioner | 363L00000X | R 203612-4 | MN | Yes |
Addresses
Primary practice location
7801 E Bush Lake Rd Ste 400
Minneapolis, MN 55439
Mailing address
7801 E Bush Lake Rd Ste 400
Minneapolis, MN 55439-3113
Phone (952) 283-3162
Other providers in Minneapolis, MN
- Robert James Bache
- Inayat Bachelani
- Nora E Bacher
- Chloe M Bachman
- Peter Clay Bachmeier
- Fouad Bachour
- Catherine Dory Bachur
- Back on Track, PLLC
- Back to Basics Chiropractic & Wellness LLC
- Terrel Backes
All providers in Minneapolis, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.