Mary Elizabeth Neill, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12982 Issued in MN

Practice address

3366 Oakdale Ave N Ste 103
Robbinsdale, MN 55422-2961

Phone

(763) 520-7870

Fax

(763) 520-7580

NPI assigned

Apr 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Elizabeth Loffhagen Former name

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edina Sports Health and Wellness, PAGroup PAC ID 7012817596, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Edina Sports Health & Wellness, PA

  dba Edina Sports and Family Medicine

  • Family Medicine Physician
  • Edina, MN
  • NPI 1215010335
  Medicare reassignment Care Compare group
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Southdale Hospital

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1124682851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 103",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222961",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 103",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222961",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LOFFHAGEN",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea R Myers, PT
• Muthu Lakshmi Narayan, DO
• Saadia Nawal, MD
• Neegard Chiropractic
• Gary Neegard, D.C.
• Joan Elizabeth Nelson, M.A.
• Rosanne Nelson, PTA
• Frederic D Nemer, MD
• Margaret A Ness, MD
• Paul V Ness, MD

• Physician Assistant in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.