Individual provider Active NPI

Elizabeth Panetta, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1437754603
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28851 Issued in MN
Practice address
204 W Franklin Ave
Minneapolis, MN 55404-2331
Phone
(611) 223-8898
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28851 MN Primary

Addresses

Primary practice location

204 W Franklin Ave
Minneapolis, MN 55404-2331

Mailing address

2126 Garfield Ave Apt 12
Minneapolis, MN 55405-3230

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810002869 MN Practitioner - Clinical Social Worker 2365825221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1300 S 2ND St
Suite 180
Minneapolis, MN 55454-5000
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28851MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Oct 9, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Oct 9, 2022 Accepting new patients

Locations

1300 S 2nd St
Ste 180
Minneapolis, MN 55454
Phone (612) 625-1500

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1437754603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 GARFIELD AVE APT 12",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042331",
            "telephone_number": "611-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANETTA",
        "first_name": "ELIZABETH",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.