Active NPI
Elizabeth Dalstrom Pai, MD
- Pediatrics Physician
- Maplewood, MN
National Provider Identifier
1508038969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 63055
- Practice address
- 1850 Beam Ave
Maplewood, MN 55109-1162 - Phone
- (651) 241-9500
- NPI assigned
- Mar 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 63055 | MN | Primary |
Addresses
Primary practice location
1850 Beam Ave
Maplewood, MN 55109-1162
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000
Other names 1
- Elizabeth Grace Dalstrom
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63055 | MN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1508038969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 BEAM AVE",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551091162",
"telephone_number": "651-241-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAI",
"first_name": "ELIZABETH",
"middle_name": "DALSTROM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-26",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "63055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "DALSTROM",
"middle_name": "GRACE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.