Michelle Lhotka, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11609 Issued in MN

Practice address

3900 Park Nicollet Blvd
Saint Louis Park, MN 55416-2503

Phone

(952) 993-3150

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Physician Assistant

Education

Other, 2004

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)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
• M Health Fairview St John's Hospital Hospital, Maplewood, MN, CCN 240210
• Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlhotka603648@fairview.direct-ci.com

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.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD (past)
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment
• Fairview Express Care

  dba M Health Fairview Sleep Center - Southdale

  • Family Medicine Physician
  • Edina, MN
  • NPI 1538542204
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Methodist Hospital

  dba Park Nicollet Methodist Hospital Outpatient Surgery Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  dba University of Minnesota Health Clinics and Surgery Center - Anesthesia

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Adult Mental Health Clinic/Center
  • St Louis Park, MN
  • NPI 1144368531
  NPD
• University of Minnesota Physicians

  dba Dental Clinic

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD (past)

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

• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  dba University of MN Medical Center, Fairview Transitional Care

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Healtheast St. John's Hospital

  dba Fairview St John's Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1467407379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE SOUTH",
            "address_2": "21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARK NICOLLET BLVD",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162503",
            "telephone_number": "952-993-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LHOTKA",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01107",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001807776",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "1069730",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Liberty Oxygen and Home Care, Inc (Liberty Oxygen and Medical Equipment)
• Michelle Libi, M.A., LMFT
• Kay Elizabeth Lichtenberger, DPT

• Physician Assistant in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.