Elizabeth Kate Blixt, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

56812 Issued in MN

Practice address

1900 Centracare Cir
Suite 2575
St Cloud, MN 56303-5000

Phone

(320) 229-4924

Fax

(320) 229-4971

NPI assigned

Jul 26, 2012

Sex

Female

Sole proprietor

No

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.

• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665

  MN

  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Lake City

  • Critical Access Hospital
  • Lake City, MN
  • NPI 1538113022

  MN

  Medicare reassignment NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Big Lake, MN
  • NPI 1013104348
  Care Compare group
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Joseph, MN
  • NPI 1134121759
  Care Compare group
• Centracare Clinic

  • Clinic/Center
  • Saint Cloud, MN
  • NPI 1164978219
  Care Compare group
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Clearwater, MN
  • NPI 1255853115
  Care Compare group
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1407858020
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • St Cloud, MN
  • NPI 1659425114
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1669994315
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Sartell, MN
  • NPI 1689196339
  Care Compare group
• Centracare Clinic

  • Urology Physician
  • Sartell, MN
  • NPI 1700281953
  Care Compare group

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

• Centracare Health System - Melrose

  • Critical Access Hospital
  • Melrose, MN
  • NPI 1720045073

  Hospital

  Care Compare affiliation
• Centracare Health System - Melrose

  • Rural Health Clinic/Center
  • Melrose, MN
  • NPI 1730407586

  Hospital

  Care Compare affiliation

Specialty

Dermatology

Education

University of North Dakota School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Clinic 800 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare Health System - Melrose Hospital Hospital, Melrose, MN, CCN 241330

Procedures performed for Medicare patients

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eblixt306015@direct.centracare.com

• Elizabeth Sand Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2016.

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1487900577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 2575",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4924",
            "fax_number": "320-229-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 2575",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4924",
            "fax_number": "320-229-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIXT",
        "first_name": "ELIZABETH",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "56812",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "107024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01238261",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Blackburn, AU.D.
• Laisha Blair
• Jill Blanchard, OTR/L
• Ellie Blaul, RBT
• Jill Bleskachek
• Erika Elizabeth Block, LPN
• Kristina Block
• Brianna Bloedorn, LICSW
• Melissa Ann Blom
• Krista Ann Blomdahl, D.C.

• All providers in St Cloud, MN
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.