NPIMap

Individual provider Active NPI

Elise H Johnson, M.D.

  • General Practice Physician
  • Shoreview, MN
National Provider Identifier
1427317023
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
56936 Issued in MN
Practice address
4194 Lexington Ave N
Shoreview, MN 55126
Phone
(651) 483-5461
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 56936 MN Primary

Addresses

Primary practice location

4194 Lexington Ave N
Shoreview, MN 55126

Mailing address

260 Cobblestone Dr
Colorado Springs, CO 80906-7624
Phone (320) 224-6038

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
I20190815001879 MN Practitioner - Family Practice 5698997773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

  • Allina Health Home Health Home health agency, Minneapolis, MN, CCN 248091
  • Home Health Care Inc Home health agency, Golden Valley, MN, CCN 248037
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System General Practice CurrentSince Jul 8, 2019 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System General Practice Current Accepting new patients
Allina Health System CurrentSince Jul 8, 2019 Accepting new patients
Allina Health System General Practice Past Accepting new patients

Locations

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

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461

Interoperability endpoints

  • Direct secure messaging: ejohnson414130@excellian.direct.allina.com

Organizations & group practices 6

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1427317023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 COBBLESTONE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067624",
            "telephone_number": "320-224-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4194 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "651-483-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELISE",
        "middle_name": "H",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "56936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

Verify at the official NPI Registry.