Individual provider Active NPI

Elizabeth Placzek, M.D.

  • Pediatrics Physician
  • West St Paul, MN
National Provider Identifier
1164836821
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
62019 Issued in MN
Practice address
963 Robert St S
West St Paul, MN 55118-1446
Phone
(651) 726-9500
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 62019 MN Primary

Addresses

Primary practice location

963 Robert St S
West St Paul, MN 55118-1446

Mailing address

345 Smith Ave N
Saint Paul, MN 55102-2346

Other identifiers 2

IdentifierTypeStateIssuer
62019OtherMNMN MEDICAL LICENSE
1164836821OtherNPI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205001511 MN Practitioner - Pediatric Medicine 9638548217 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62019MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Clinic Network CurrentSince Oct 28, 2022 Accepting new patients
Children's Clinic Network Current Accepting new patients
Children's Clinic Network CurrentSince Oct 28, 2022 Accepting new patients
Metropolitan Pediatric Specialists, P.a. Past Accepting new patients

Locations

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

1547 Livingston Ave
West St Paul, MN 55118
Phone (651) 451-8050

963 Robert St S
West St Paul, MN 55118
Phone (651) 726-9500

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164836821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 ROBERT ST S",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551181446",
            "telephone_number": "651-726-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACZEK",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2023-03-07",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "62019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAL LICENSE",
            "identifier": "62019",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164836821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

Verify at the official NPI Registry.