Active NPI
Emily Michelle Anderson, P.A.
- Physician Assistant
- Minneapolis, MN
National Provider Identifier
1124329503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1511
- Practice address
- 701 Park Ave
R1
Minneapolis, MN 55415-1623 - Phone
- (612) 873-3131
- Fax
- (612) 904-4242
- NPI assigned
- Nov 16, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1511 | MN | Primary |
Addresses
Primary practice location
701 Park Ave
R1
Minneapolis, MN 55415-1623
Mailing address
914 S 8TH St
S6
Minneapolis, MN 55404-1210
Phone (612) 347-5320
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.
-
- Diagnostic Radiology Physician
- Waconia, MN
- NPI 1811174923
-
- General Practice Physician
- Minneapolis, MN
- NPI 1063459485
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1407897309
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110114000977 | MN | Practitioner - Physician Assistant | 4284823626 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1511 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sibley Medical Center | Current | Accepting new patients | |
| Ridgeview Medical Center | Current | Accepting new patients | |
| Hennepin Faculty Associates | Past | Accepting new patients | |
| Hennepin Healthcare System, Inc | Past | Accepting new patients |
Locations
601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271
7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570
111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001
621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375
500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1124329503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 S 8TH ST",
"address_2": "S6",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554041210",
"telephone_number": "612-347-5320",
"fax_number": "612-373-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"address_2": "R1",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-3131",
"fax_number": "612-904-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "EMILY",
"middle_name": "MICHELLE",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-16",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "1511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.