Individual provider Active NPI

Elizabeth Richardson

  • Emergency Medicine Physician
  • Bloomington, MN
National Provider Identifier
1275067902
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
73448 Issued in MN
Practice address
4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435
Phone
(952) 767-4574
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 7078 OK
Emergency Medicine Physician 207P00000X 0322R OK
Emergency Medicine Physician 207P00000X 73448 MN Primary

Addresses

Primary practice location

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 767-4574

Other practice location 1

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 767-4574

Other practice location 2

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 767-4574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210831000099 TX Practitioner - Emergency Medicine 5294146650 Reassigns benefits to 2 organizations
I20230731001538 MN Practitioner - Emergency Medicine 5294146650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7078OKMDMental Health Counselor
0322ROKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Aug 27, 2021 Accepting new patients
Emergency Physicians Professional Association Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Aug 27, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 28, 2021 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Emergency Physicians Professional Association CurrentSince Aug 1, 2023 Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Organizations & group practices 6

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 5

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1275067902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKET PTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-767-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKET PTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-767-4574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352104",
            "country_code": "US",
            "telephone_number": "952-767-4574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 E Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553375714",
            "country_code": "US",
            "telephone_number": "952-767-4574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7078",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0322R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "73448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.