NPIMap

Individual provider Active NPI

Ismar Terzic, PA

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1316552466
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2211 Riverside Ave
Minneapolis, MN 55454-1350
Phone
(612) 330-1388
NPI assigned
Sep 14, 2020
Last updated
May 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2211 Riverside Ave
Minneapolis, MN 55454-1350

Mailing address

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

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456

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
I20221221001211 MN Practitioner - Physician Assistant 1951771674 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Mar 6, 2023 Accepting new patients
Regions Hospital CurrentSince Mar 6, 2023 Accepting new patients
Mille Lacs Health System CurrentSince Nov 1, 2025 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Mar 6, 2023 Accepting new patients
Glencoe Regional Health Services CurrentSince Dec 12, 2022 Accepting new patients
Glencoe Regional Health Services CurrentSince Dec 12, 2022 Accepting new patients
Mille Lacs Health System CurrentSince Dec 22, 2025 Accepting new patients
Lakeview Memorial Hospital Association Inc. CurrentSince Mar 6, 2023 Accepting new patients
Mille Lacs Health System CurrentSince Nov 1, 2025 Accepting new patients
Allina Health System CurrentSince Oct 1, 2024 Accepting new patients
Allina Health System CurrentSince Oct 1, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300

11269 Jefferson Hwy N
Champlin, MN 55316
Phone (763) 236-0600

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

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

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

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

2000 Joseph E Sanker Blvd
Norwood, OH 45212
Phone (513) 841-7400

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 11

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1316552466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541350",
            "telephone_number": "612-330-1388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERZIC",
        "first_name": "ISMAR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.