NPIMap

Individual provider Active NPI

Elizabeth Ann Hodenfield

  • Physician Assistant
  • Coon Rapids, MN
National Provider Identifier
1467140152
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568
Phone
(763) 427-9980
Fax
(763) 427-0904
NPI assigned
May 1, 2023
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 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

4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

2 Pine Tree Dr
Saint Paul, MN 55112-3754
Phone (651) 635-8000

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
I20241007002454 MN Practitioner - Physician Assistant 4587195144 Reassigns benefits to 1 organization

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
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

520 Osborne Rd NE
Fridley, MN 55432-2718

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone (763) 427-9980

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15079MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Oct 1, 2024 Accepting new patients
Allina Health System CurrentSince Oct 1, 2024 Accepting new patients

Locations

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

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

4040 Coon Rapids Blvd NW
Ste 120
Minneapolis, MN 55433
Phone (763) 427-9980

Interoperability endpoints

  • Direct secure messaging: lolson653473@excellian.direct.allina.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1467140152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW STE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334568",
            "telephone_number": "763-427-9980",
            "fax_number": "763-427-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Pine Tree Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551123754",
            "country_code": "US",
            "telephone_number": "651-635-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODENFIELD",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.