Individual provider Active NPI

Danielle Vlazny, PA-C

  • Physician Assistant
  • Rochester, MN
National Provider Identifier
1477930790
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11860 Issued in MN
Practice address
200 1St St SW
Gonda 4-300
Rochester, MN 55905-0001
Phone
(507) 266-1111
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 11860 MN Primary

Addresses

Primary practice location

200 1St St SW
Gonda 4-300
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Gonda 4-300
Rochester, MN 55905-0001
Phone (507) 266-1111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dvlazny142276@ehrdirect.mayoclinicmsg.org

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000420 MN Practitioner - Physician Assistant 4789997800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

201 W Ctr St
Rochester, MN 55902-3003
Phone (507) 255-5123

4544 Canal PL SE
Rochester, MN 55904-4010
Phone (507) 293-8500

Hospital & facility affiliations

  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11860MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Jul 29, 2015 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

200 1st St SW
#4300
Rochester, MN 55905
Phone (507) 266-1111

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: dvlazny142276@ehrdirect.mayoclinicmsg.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1477930790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "address_2": "GONDA 4-300",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-266-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "address_2": "GONDA 4-300",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-266-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLAZNY",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvlazny142276@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "address_2": "Gonda 4-300",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.