NPIMap

Individual provider Active NPI

Elizabeth Ann Pesek, MD

  • Obstetrics & Gynecology Physician
  • Eagan, MN
National Provider Identifier
1104082411
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
52858 Issued in MN
Practice address
2805 Dodd Rd Ste 100
Eagan, MN 55121-2160
Phone
(651) 241-7733
Fax
(651) 241-0258
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 13661 ND
Obstetrics & Gynecology Physician 207V00000X 52858 MN Primary

Addresses

Primary practice location

2805 Dodd Rd Ste 100
Eagan, MN 55121-2160

Mailing address

2805 Dodd Rd Ste 100
Eagan, MN 55121-2160
Phone (651) 241-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923001559 MN Practitioner - Obstetrics/Gynecology 8325164668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier OBGYN of Minnesota PLLCGroup PAC ID 1355396110, 88 clinicians

Practice addresses (Care Compare)

2945 Hazelwood St
Suite 210
Maplewood, MN 55109-1243
Phone (651) 770-3320

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Merit-based Incentive Payment System (MIPS)

Final score
87.24 of 100Reported as group
Quality
86.35
Promoting interoperability
100
Improvement activities
40
Cost
71.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52858MNMDObstetrics & Gynecology Physician
13661NDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier OBGYN of Minnesota PLLC Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Genneve Medical P.C. PastSince Sep 1, 2024 Accepting new patients
Metropolitan Obstetrics & Gynecology Obstetrics & Gynecology Past Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients
Healtheast Woodwinds Hospital 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

10900 Wayzata Blvd
Ste 640
Minnetonka, MN 55305

971 Sibley Memorial Hwy
Ste 350
Saint Paul, MN 55118
Phone (651) 770-3320

2945 Hazelwood St
Ste 210
Saint Paul, MN 55109
Phone (651) 770-3320

1875 Woodwinds Dr
Ste 100
Woodbury, MN 55125
Phone (651) 232-6380

Interoperability endpoints

  • Direct secure messaging: elizabeth.pesek.1@20897.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1104082411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 DODD RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212160",
            "telephone_number": "651-241-7733",
            "fax_number": "651-241-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 DODD RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212160",
            "telephone_number": "651-241-7733",
            "fax_number": "651-241-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESEK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "13661",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "52858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.