Brooke Leigh Elvehjem, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13897 Issued in MN

Practice address

4480 Centerville Rd
White Bear Lake, MN 55127-3674

Phone

(651) 484-2724

NPI assigned

Dec 7, 2021

Last updated

Mar 4, 2022By the provider in NPPES

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

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  MN

  Medicare reassignment Care Compare group
• Advanced Dermatology Care Medical Cosmetic and Surgery PA

  dba Advanced Dermatology Care

  • Dermatology Physician
  • White Bear Lake, MN
  • NPI 1073614558
  Medicare reassignment
• Advanced Dermatology Care Medical Cosmetic and Surgery PA

  dba Advanced Dermatology Care

  • Dermatology Physician
  • Forest Lake, MN
  • NPI 1912158031
  NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1174281034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 CENTERVILLE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551273674",
            "telephone_number": "651-484-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 CENTERVILLE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551273674",
            "telephone_number": "651-484-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELVEHJEM",
        "first_name": "BROOKE",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chadaya Eggleston
• Leah Eichmiller, L.AC.
• Jeffrey D Elbers, MD
• Paige Ellefson
• Hannah Ellingson
• Paul R Endres, LP
• Jessica Ann Engman, OTR/L
• Dorothy Carmelite Enockson Sr., LICSW
• Enrichmentgroup (Haven for Hope MN)
• Nora Marie Erdrich

• Physician Assistant in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.