Individual provider Active NPI

Cassandra Edson, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1497185052
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11447 Issued in MN
Practice address
9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682
Phone
(763) 302-4118
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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 11447 MN Primary

Addresses

Primary practice location

9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682

Mailing address

9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682
Phone (763) 302-4118

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cedson187026@direct.northmemorial.com Direct Minneapolis Clinic of Neurology, Ltd

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
I20131230001031 MN Practitioner - Physician Assistant 2860629516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Merit-based Incentive Payment System (MIPS)

Final score
92.39 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
83.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11447MNMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cedson187026@direct.northmemorial.com

Organizations & group practices 1

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1497185052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692682",
            "telephone_number": "763-302-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692682",
            "telephone_number": "763-302-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSON",
        "first_name": "CASSANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cedson187026@direct.northmemorial.com",
            "affiliation": "Y",
            "affiliationName": "Minneapolis Clinic of Neurology, Ltd",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9645 Grove Cir N Ste 100",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553692682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.