Stephanie P Elko, MPAS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10118 Issued in MN

Practice address

2265 Como Ave
Saint Paul, MN 55108-1737

Phone

(888) 364-5977

NPI assigned

Jun 27, 2006

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 identifiers 1

Other names 1

• Stephanie P Faust Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Metropolitan Obstetrics & Gynecology

  • Obstetrics & Gynecology Physician
  • St Paul, MN
  • NPI 1659355741
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1508893561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 ROMA AVE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136723",
            "telephone_number": "612-236-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737",
            "telephone_number": "888-364-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1965 Ford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551161923",
            "country_code": "US",
            "telephone_number": "651-696-5640",
            "fax_number": "651-696-5543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Metro OBGYN",
            "address_2": "17 W Exchange St.",
            "address_purpose": "LOCATION",
            "city": "St. Paul",
            "state": "MN",
            "postal_code": "55102",
            "country_code": "US",
            "telephone_number": "651-227-9141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Augsburg University",
            "address_2": "2211 Riverside Avenue",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55454",
            "country_code": "US",
            "telephone_number": "612-330-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELKO",
        "first_name": "STEPHANIE",
        "middle_name": "P",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10118",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694183400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "FAUST",
            "middle_name": "P",
            "credential": "MPAS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.