Erin Marie Gottesleben, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12966 Issued in MN

Practice address

6363 France Ave S Ste 400
Edina, MN 55435-2142

Phone

(952) 920-2070

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermed Consultants Dialysis PLLCGroup PAC ID 7012225105, 11 clinicians

Intermed Consultants,LTD.Group PAC ID 8022033372, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: erin.gottesleben@direct.davitaphysiciansolutions.com

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.

• Intermed Consultants Dialysis, PLLC

  • Nephrology Physician
  • Edina, MN
  • NPI 1376912857
  Medicare reassignment Care Compare group
• Intermed Consultants,LTD.

  • Nephrology Physician
  • Edina, MN
  • NPI 1962596221
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1225199128
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1346706645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352130",
            "telephone_number": "952-920-2070",
            "fax_number": "952-920-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352142",
            "telephone_number": "952-920-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESLEBEN",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Marie Gosen, RN, CNP
• Richard Bruce Gosen, MD
• Gary Gosewisch, MD
• Got Your Back Chiropractic and Wellness Clinic P.C.
• Paul S. Gotlieb, M.D.
• Jennifer Ann Goudy, MA
• Isabella Goulett
• Elise Graham, RD, LD
• Justin Donald Graham, M.D.
• Maggie Allison Graham, MSW, LICSW

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.