Individual provider Active NPI

Christine Earll, PA-C

  • Physician Assistant
  • Buffalo, MN
National Provider Identifier
1366212136
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14716 Issued in MN
Practice address
1700 Highway 25 N
Buffalo, MN 55313-1930
Phone
(763) 682-1313
Fax
(763) 581-9090
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 14716 MN Primary

Addresses

Primary practice location

1700 Highway 25 N
Buffalo, MN 55313-1930

Mailing address

1700 Highway 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

Other practice location 1

1001 Hart Blvd Ste 100
Monticello, MN 55362-8929
Phone (763) 295-2921

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cluce203351@direct.northmemorial.com
Direct Messaging Address cluce203351@direct.northmemorial.com

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
I20240131000215 MN Practitioner - Physician Assistant 0547613127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stellis Health, PAGroup PAC ID 1153233796, 54 clinicians

Practice addresses (Care Compare)

1001 Hart Blvd
Suite 100
Monticello, MN 55362-8929
Phone (763) 682-1313

1700 Hwy 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14716MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stellis Health, PA CurrentSince Feb 1, 2024 Accepting new patients
Stellis Health, PA CurrentSince Feb 1, 2024 Accepting new patients

Locations

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

1001 Hart Blvd
Ste 100
Monticello, MN 55362
Phone (763) 295-2921

Interoperability endpoints

  • Direct secure messaging: cluce203351@direct.northmemorial.com

Organizations & group practices 2

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1366212136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313",
            "fax_number": "763-581-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Hart Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MN",
            "postal_code": "553628929",
            "country_code": "US",
            "telephone_number": "763-295-2921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARLL",
        "first_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cluce203351@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1700 Highway 25 N",
            "city": "Buffalo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553131930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cluce203351@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.