Jeannine Pamela Phillips, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10348 Issued in MN

Practice address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544

Phone

(763) 267-8701

NPI assigned

Nov 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
• Home Health Care Inc Home health agency, Golden Valley, MN, CCN 248037
• Ecumen Hospice Hospice, Shoreview, MN, CCN 241557

Merit-based Incentive Payment System (MIPS)

Final score

86.11 of 100Reported as group

Quality

70.97

Improvement activities

40

Cost

73.58

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Twin Cities Physicians Professional Corporation

  • Multi-Specialty Clinic/Center
  • Golden Valley, MN
  • NPI 1992176499
  Medicare reassignment Care Compare group
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MN

  Medicare reassignment

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

• Adara Home Health, Inc.

  • Home Health Agency
  • Buffalo, MN
  • NPI 1063420198
  Care Compare affiliation
• Ecumen

  dba Ecumen Hospice

  • Community Based Hospice Care Agency
  • Shoreview, MN
  • NPI 1376682781
  Care Compare affiliation
• Home Health Care, Incorporated

  • Home Health Registered Nurse
  • Golden Valley, MN
  • NPI 1255440061

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1528248903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JEANNINE",
        "middle_name": "PAMELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP85889",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "154N5PH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00474995",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "139989",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178452100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul William Peterson, D.D.S.
• Nicole Lynn Pfeffer, COTA/L
• Lucinda S Phair, RN MA MSCN
• Mara Pham, NP
• Branden David Phillips, LICSW
• Stephanie Anne Pickthorn
• Pillpack LLC (Amazon Pharmacy #013)
• Marilyn Pineo
• Nikole Allyce Pitman, LPCC
• Brittany Ann Poff, FNP

• Medical Physician Assistant in Golden Valley, MN
• Providers in Golden Valley, 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 Nov 11, 2019; 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.