NPIMap

Individual provider Active NPI

Nicholas Dale Beaudoin

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1194205526
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
913 E 26TH St Ste 600
Minneapolis, MN 55404
Phone
(612) 775-6200
NPI assigned
Aug 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

913 E 26TH St Ste 600
Minneapolis, MN 55404

Mailing address

913 E 26TH St Ste 600
Minneapolis, MN 55404-4515
Phone (612) 775-6200

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
I20181121002337 MN Practitioner - Physician Assistant 5496009870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

18465 Orchard TRL
Suite 220
Lakeville, MN 55044-2520
Phone (800) 827-8313

225 Smith Ave N
Suite 100
Saint Paul, MN 55102-2533
Phone (651) 292-0007

2305 108TH LN NE
Blaine, MN 55449-5222
Phone (612) 775-6200

2855 Campus Dr
Plymouth, MN 55441-2683

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

800 E 28TH St
Minneapolis, MN 55407-3723

8675 Valley Creek Rd
Woodbury, MN 55125-2337
Phone (651) 241-3000

913 E 26TH St
Minneapolis, MN 55404-4515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Oct 4, 2018 Accepting new patients
Allina Health System CurrentSince Oct 4, 2018 Accepting new patients
Gillette Children's Specialty Healthcare Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2305 108th Ln NE
Blaine, MN 55449
Phone (763) 278-4429

913 E 26th St
#600
Minneapolis, MN 55404
Phone (612) 775-6154

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

11850 Blackfoot St NW
Ste 405
Minneapolis, MN 55433
Phone (763) 236-0888

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2855 Campus Dr
Ste 600
Plymouth, MN 55441
Phone (612) 333-4822

1155 County Road E E
Ste 100
Vadnais Heights, MN 55110
Phone (651) 241-9200

Interoperability endpoints

  • Direct secure messaging: nicholas.beaudoin.p2@direct.tcspine.nextgenshare.com

Organizations & group practices 8

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1194205526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 E 26TH ST STE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044515",
            "telephone_number": "612-775-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 E 26TH ST STE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-775-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "NICHOLAS",
        "middle_name": "DALE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.