NPIMap

Individual provider Active NPI

Heather Gabrielle Guertin, PA

  • Physician Assistant
  • Lakeville, MN
National Provider Identifier
1265968374
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12460 Issued in MN
Practice address
18465 Orchard TRL
Lakeville, MN 55044-8885
Phone
(952) 428-0950
NPI assigned
May 10, 2017
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 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 12460 MN Primary

Addresses

Primary practice location

18465 Orchard TRL
Lakeville, MN 55044-8885

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

2603 39th Ave NE Ste D-202
Minneapolis, MN 55421-4372
Phone (612) 213-2370

Other names 1

  • Heather Gabrielle Ebert Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hebert195192@excellian.direct.allina.com Direct

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
I20170825001665 MN Practitioner - Physician Assistant 2466724430 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

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

500 Osborne Rd NE
Suite 150
Fridley, MN 55432-2770
Phone (763) 236-2500

7920 Old Cedar Ave S
Bloomington, MN 55425-1207
Phone (952) 428-1800

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

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

State licenses

LicenseStateTypeSpecialty
12460MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 8, 2024 Accepting new patients
Allina Health System CurrentSince Jul 8, 2024 Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

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

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

Interoperability endpoints

  • Direct secure messaging: hebert195192@excellian.direct.allina.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1265968374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18465 ORCHARD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448885",
            "telephone_number": "952-428-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2603 39th Ave NE Ste D-202",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554214372",
            "country_code": "US",
            "telephone_number": "612-213-2370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERTIN",
        "first_name": "HEATHER",
        "middle_name": "GABRIELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hebert195192@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "18465 Orchard Trl",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550448885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "EBERT",
            "middle_name": "GABRIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.