Individual provider Active NPI

Elizabeth Ann Griffin, PA-C

  • Physician Assistant
  • Stillwater, MN
National Provider Identifier
1285949677
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11101 Issued in MN
Practice address
921 Greeley St S
Stillwater, MN 55082-5935
Phone
(651) 439-1234
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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 11101 MN Primary

Addresses

Primary practice location

921 Greeley St S
Stillwater, MN 55082-5935

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other identifiers 3

IdentifierTypeStateIssuer
085003802OtherILLISCENSED PHYSICIAN ASSISTANT
1092809OtherNCCPA
11101OtherMNLICENSED PHYSICIAN ASSISTANT

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
I20121019000508 MN Practitioner - Physician Assistant 2769663434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

921 Greeley S St
Stillwater, MN 55082-5935
Phone (651) 439-1234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11101MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Plan, Inc. CurrentSince Jan 18, 2021 Accepting new patients
Group Health, Inc. CurrentSince Jan 18, 2021 Accepting new patients
North Memorial Health Care CurrentSince Mar 1, 2018 Accepting new patients
Group Health, Inc. Past Accepting new patients
Lakeview Memorial Hospital Association Inc. Past Accepting new patients
Hennepin Healthcare System, Inc Past Accepting new patients
Joseph J. Furlin, M.D., S.C. PastSince May 1, 2022 Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

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

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

701 Park Ave
#R1060
Minneapolis, MN 55415

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

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

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

921 Greeley St S
West Lakeland, MN 55082

Organizations & group practices 7

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": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1285949677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GREELEY ST S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825935",
            "telephone_number": "651-439-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSED PHYSICIAN ASSISTANT",
            "identifier": "085003802",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1092809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PHYSICIAN ASSISTANT",
            "identifier": "11101",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.