Individual provider Active NPI

Lisa Marie Elstad, MD

  • Family Medicine Physician
  • Chanhassen, MN
National Provider Identifier
1235371667
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54984 Issued in MN
Practice address
300 Lake Dr E
Chanhassen, MN 55317-9302
Phone
(952) 993-4421
NPI assigned
Mar 31, 2009
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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 54984 MN Primary

Addresses

Primary practice location

300 Lake Dr E
Chanhassen, MN 55317-9302

Mailing address

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000311 MN Practitioner - Family Practice 2860640307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8455 Flying Cloud Dr
Eden Prairie, MN 55344-3974
Phone (952) 993-7400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Aug 6, 2012 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients

Locations

300 Lake Dr E
Chanhassen, MN 55317
Phone (952) 993-4300

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Interoperability endpoints

  • Direct secure messaging: lelstad41832@direct.healthpartners.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1235371667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LAKE DR E",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179302",
            "telephone_number": "952-993-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAKE DR E",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179302",
            "telephone_number": "952-993-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSTAD",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "54984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

Verify at the official NPI Registry.