NPIMap

Individual provider Active NPI

Russel A Warnsholz, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1487988523
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10674 Issued in MN
Practice address
4040 Radio Dr
Woodbury, MN 55129-3237
Phone
(514) 398-8076
Fax
(651) 439-0232
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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 10674 MN Primary

Addresses

Primary practice location

4040 Radio Dr
Woodbury, MN 55129-3237

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100106000835 MN Practitioner - Physician Assistant 5395886741 Reassigns benefits to 2 organizations
I20240229004161 WI Practitioner - Physician Assistant 5395886741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

2211 Vine St
Hudson, WI 54016-1899
Phone (715) 386-1155

2651 Hillcrest Dr
Suite 101
Hudson, WI 54016-9919
Phone (800) 423-1088

2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Jul 15, 2018 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jun 2, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 15, 2018 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jun 2, 2021 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

3545 Highway 61 N
Vadnais Heights, MN 55110

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

2651 Hillcrest Dr
Ste 101
Hudson, WI 54016
Phone (800) 423-1088

Organizations & group practices 7

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 12

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1487988523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293237",
            "telephone_number": "514-398-8076",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNSHOLZ",
        "first_name": "RUSSEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.