Individual provider Active NPI

Elaine Marie Hoffman Holstine, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1477516482
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39794 Issued in MN
Practice address
2220 Riverside Ave
Ms 31700a
Minneapolis, MN 55454-1321
Phone
(952) 967-7175
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39794 MN
Internal Medicine Physician 207R00000X 39794 MN Primary

Addresses

Primary practice location

2220 Riverside Ave
Ms 31700a
Minneapolis, MN 55454-1321

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (952) 967-7175

Other practice location 1

10705 Town Square Dr NE
Suite 100
Blaine, MN 55449-8184
Phone (763) 236-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051221000701 MN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4880616549 Reassigns benefits to 2 organizations
I20200520000865 TX Practitioner - Internal Medicine 4880616549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39794MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Family Healthcare CurrentSince Nov 24, 2020 Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 1, 2020 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Unity Family Healthcare CurrentSince Nov 24, 2020 Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 1, 2020 Accepting new patients
Columbia Park Medical Group, PA Internal Medicine Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000

Interoperability endpoints

  • Direct secure messaging: ehoffmanholstine545511@direct.centracare.com

Organizations & group practices 6

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1477516482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-967-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 RIVERSIDE AVE",
            "address_2": "MS 31700A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541321",
            "telephone_number": "952-967-7175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10705 Town Square Dr NE",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554498184",
            "country_code": "US",
            "telephone_number": "763-236-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFFMAN HOLSTINE",
        "first_name": "ELAINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "39794",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "39794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.