Individual provider Active NPI

Katherine Ellen Tilton Tomscha, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1225674971
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13620 Issued in MN
Practice address
9855 Hospital Dr
Maple Grove, MN 55369-4648
Phone
(763) 581-5900
Fax
(763) 581-5901
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 13620 MN Primary

Addresses

Primary practice location

9855 Hospital Dr
Maple Grove, MN 55369-4648

Mailing address

9855 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-5900

Other names 1

  • Miss Katherine Ellen Wilson Tilton Former name

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
I20210621001027 MN Practitioner - Physician Assistant 4385044817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

15450 Hwy 7
Minnetonka, MN 55345-3522

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

800 Freeport Ave NW
Elk River, MN 55330-2723
Phone (763) 581-2273

8559 Edinbrook Pkwy
Suite 100
Brooklyn Park, MN 55443-3728
Phone (763) 581-2273

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Jan 1, 2022 Accepting new patients

Locations

9855 Hospital Dr
Ste 102
Maple Grove, MN 55369
Phone (763) 581-5800

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9855 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-5800

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: ktilton168808@direct.northmemorial.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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1225674971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9855 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "763-581-5900",
            "fax_number": "763-581-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "763-581-5900",
            "fax_number": "763-581-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMSCHA",
        "first_name": "KATHERINE",
        "middle_name": "ELLEN TILTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "TILTON",
            "middle_name": "ELLEN WILSON",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.