Individual provider Active NPI

Ellie Van Gilder, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1407695018
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 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 Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 1

2238 16 3/4 Ave
Rice Lake, WI 54868-8786
Phone (715) 651-5527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250709000765 MN Practitioner - Physician Assistant 9739693094 Reassigns benefits to 1 organization
I20251112000338 WI Practitioner - Physician Assistant 9739693094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

402 E 2ND St
Duluth, MN 55805-1906
Phone (218) 786-4000

502 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

530 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Jul 14, 2025 Accepting new patients
The Duluth Clinic LTD CurrentSince Jul 14, 2025 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Sep 1, 2025 Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 4

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 4

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1407695018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2238 16 3/4 Ave",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548688786",
            "country_code": "US",
            "telephone_number": "715-651-5527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN GILDER",
        "first_name": "ELLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.