Individual provider Active NPI

Lisa M Hoepner, PA-C

  • Physician Assistant
  • Plymouth, MN
National Provider Identifier
1215024807
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9354 Issued in MN
Practice address
2800 Campus Dr Ste 20
Plymouth, MN 55441-2669
Phone
(763) 257-8000
NPI assigned
Oct 6, 2006
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 9354 MN Primary

Addresses

Primary practice location

2800 Campus Dr Ste 20
Plymouth, MN 55441-2669

Mailing address

2800 Campus Dr Ste 10
Plymouth, MN 55441-8812
Phone (763) 257-8000

Other practice location 1

800 Freeport Ave NW
Ste 100A
Elk River, MN 55330-2723
Phone (763) 257-8000

Other identifiers 1

IdentifierTypeStateIssuer
697695600MedicaidMN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080315000027 MN Practitioner - Physician Assistant 2264517259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Imaging LLCGroup PAC ID 7315833720, 29 clinicians

Practice addresses (Care Compare)

2800 Campus Dr
Plymouth, MN 55441-2669

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9354MNMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1215024807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418812",
            "telephone_number": "763-257-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412669",
            "telephone_number": "763-257-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Freeport Ave NW",
            "address_2": "Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553302723",
            "country_code": "US",
            "telephone_number": "763-257-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOEPNER",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "697695600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.