NPIMap

Individual provider Active NPI

Jeffrey D Elbers, MD

  • Family Medicine Physician
  • White Bear Lake, MN
National Provider Identifier
1174547723
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36523 Issued in MN
Practice address
4786 Banning Ave
White Bear Lake, MN 55110-3264
Phone
(651) 426-6402
Fax
(651) 429-3402
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36523 MN Primary

Addresses

Primary practice location

4786 Banning Ave
White Bear Lake, MN 55110-3264

Mailing address

2025 Sloan PL
Suite 35
Saint Paul, MN 55117-2007
Phone (651) 772-1572

Other identifiers 1

IdentifierTypeStateIssuer
931220000MedicaidMN

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
I20071215000203 MN Practitioner - Family Practice 8820900947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Healthservices Minnesota PAGroup PAC ID 1355369018, 55 clinicians

Practice addresses (Care Compare)

14688 Everton Ave N
Hugo, MN 55038-6071
Phone (651) 788-4444

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Allina Health Home Health Home health agency, Minneapolis, MN, CCN 248091
  • St Croix Hospice Hospice, Oakdale, MN, CCN 241586
  • 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
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Jan 1, 2008 Accepting new patients

Locations

14688 Everton Ave N
Hugo, MN 55038
Phone (651) 326-7701

2980 Buckley Way
Inver Grove Heights, MN 55076
Phone (651) 457-2748

2716 Upper Afton Rd E
Saint Paul, MN 55119
Phone (651) 739-5050

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

404 Highway 96 W
Shoreview, MN 55126
Phone (651) 482-8080

4786 Banning Ave
White Bear Lake, MN 55110
Phone (651) 426-6402

Interoperability endpoints

  • Direct secure messaging: jeffrey.elbers@entira.eclinicaldirectplus.com

Organizations & group practices 2

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 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1174547723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL",
            "address_2": "SUITE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172007",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4786 BANNING AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103264",
            "telephone_number": "651-426-6402",
            "fax_number": "651-429-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBERS",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "931220000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.