Stephanie Ernesta Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11653 Issued in MN

Practice address

1580 Beam Ave
Maplewood, MN 55109-1127

Phone

(651) 779-7978

Fax

(651) 779-7656

NPI assigned

Aug 4, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Ernesta Johnson Former name

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
• M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Merit-based Incentive Payment System (MIPS)

Final score

89.19 of 100Reported as apm

Quality

72.34

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.smith@moh.ikm.direct-ci.com

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.

• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1528035995

  WI

  Medicare reassignment Care Compare group NPD
• Minnesota Oncology Hematology PA

  • Community/Retail Pharmacy
  • Maple Grove, MN
  • NPI 1811601123
  NPD
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Fridley, MN
  • NPI 1356585442
  NPD
• Minnesota Oncology Hematology, PA

  • Radiation Oncology Physician
  • Saint Paul, MN
  • NPI 1598305427
  NPD (past)
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1609911205
  NPD (past)

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

• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation
• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1508275603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 110N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551142001",
            "telephone_number": "651-602-5311",
            "fax_number": "651-222-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091127",
            "telephone_number": "651-779-7978",
            "fax_number": "651-779-7656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 Hillcrest Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540169919",
            "country_code": "US",
            "telephone_number": "715-280-9151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "ERNESTA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7134-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "JOHNSON",
            "middle_name": "ERNESTA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Smiles in Motion of Minnesota PC
• Aynsley D Smith, CNP
• Coreen S Smith, CNP, MS
• Elizabeth Anne Smith, MD
• Megan Kristine Smith
• April Marie Snyder, D.D.S.
• James R Snyder, PA
• De Mo Soe, INTERPRETER
• Ruth Sohl-Kreiger, RN, MS,GNP
• Luke William Solheid, PA

• Physician Assistant in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.