Elizabeth Kay Thelen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13872 Issued in MN

Practice address

8540 Quaday Ave NE
Otsego, MN 55330-6522

Phone

(763) 441-0298

Fax

(763) 441-0591

NPI assigned

Oct 20, 2021

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

Other names 1

• Elizabeth Kay Lastovich Former name

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score

91.79 of 100Reported as group

Quality

95.08

Improvement activities

40

Cost

81.67

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  Medicare reassignment Care Compare group NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • Hudson, WI
  • NPI 1568840916
  NPD
• St. Croix Orthopaedics, PA

  • Specialist
  • Oak Park Heights, MN
  • NPI 1255337945
  NPD (past)
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

• Allina Health System

  • Addiction (Substance Use Disorder) Psychologist
  • Fridley, MN
  • NPI 1083197214

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Cambridge, MN
  • NPI 1215755400
  Care Compare affiliation
• Allina Health System

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Fridley, MN
  • NPI 1285692145
  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1316904287
  Care Compare affiliation
• Allina Health System

  • Radiation Oncology Clinic/Center
  • Buffalo, MN
  • NPI 1417548959

  Hospital

  Care Compare affiliation
• Allina Health System

  • Maternal & Fetal Medicine Physician
  • Coon Rapids, MN
  • NPI 1447527767

  Hospital

  Care Compare affiliation
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1598700528

  Hospital

  Care Compare affiliation
• Allina Health System

  • Psychiatric Hospital Unit
  • Fridley, MN
  • NPI 1609056100
  Care Compare affiliation

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1427711183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 QUADAY AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306522",
            "telephone_number": "763-441-0298",
            "fax_number": "763-441-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "ELIZABETH",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LASTOVICH",
            "middle_name": "KAY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.