Individual provider Active NPI

Gina Sejin Dahlin, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1235109356
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9956 Issued in MN
Practice address
777 Raymond Ave
Saint Paul, MN 55114-1522
Phone
(952) 484-7661
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9956 MN
Physician Assistant 363A00000X 9956 MN Primary

Addresses

Primary practice location

777 Raymond Ave
Saint Paul, MN 55114-1522

Mailing address

4570 W 77TH St
Ste 150
Edina, MN 55435-5038
Phone (952) 567-7400

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
I20051222000150 MN Practitioner - Physician Assistant 6002838729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emily Program P CGroup PAC ID 5193623254, 49 clinicians

Practice addresses (Care Compare)

1449 Cleveland Ave N
Saint Paul, MN 55108-1413
Phone (651) 645-5323

2265 Como Ave
Saint Paul, MN 55108-1737
Phone (651) 645-5323

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince Apr 11, 2022 Accepting new patients
Northstar Sleep Center LLC Past Accepting new patients

Locations

2265 Como Ave
Saint Paul, MN 55108

Interoperability endpoints

  • Direct secure messaging: gina.dahlin.p1@direct.mlcmsi.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1235109356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 W 77TH ST",
            "address_2": "STE 150",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355038",
            "telephone_number": "952-567-7400",
            "fax_number": "952-852-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141522",
            "telephone_number": "952-484-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLIN",
        "first_name": "GINA",
        "middle_name": "SEJIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "9956",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.