Individual provider Active NPI

Carrie J Marzolf, PA

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1467643072
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13507 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-0063
Fax
(651) 254-5535
NPI assigned
Aug 8, 2007
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0902 NH
Physician Assistant 363A00000X PA001104 ME
Physician Assistant 363A00000X 13507 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (651) 254-0063

Other names 1

  • Mrs. Carrie J Marzolf Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201209003213 MN Practitioner - Physician Assistant 0143303487 Reassigns benefits to 4 organizations
I20240118001999 WI Practitioner - Physician Assistant 0143303487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians

Practice addresses (Care Compare)

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1555

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0902NHMDCounselor
PA001104MEMDPhysician Assistant
13507MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Dec 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Dec 1, 2021 Accepting new patients
Ladd Memorial Hospital CurrentSince Dec 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Dec 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Mainehealth Past Accepting new patients
Ladd Memorial Hospital Past Accepting new patients
Allergy and Asthma Center of Minnesota PLLC Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

2600 65th Ave
Osceola, WI 54020
Phone (705) 268-8000

Interoperability endpoints

  • Direct secure messaging: cmarzolf650884@excellian.direct.allina.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1467643072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-0063",
            "fax_number": "651-254-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-0063",
            "fax_number": "651-254-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOLF",
        "first_name": "CARRIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0902",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001104",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "MARZOLF",
            "middle_name": "J",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.