Active NPI
Shauna Marissa Pankratz
- Physician Assistant
- Spring Lake Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 8232 Highway 65 NE
Spring Lake Park, MN 55432-2095 - Phone
- (763) 577-1877
- Fax
- (763) 577-1887
- NPI assigned
- Jun 15, 2011
- Last updated
- Jun 15, 2011
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
8232 Highway 65 NE
Spring Lake Park, MN 55432-2095
Mailing address
2355 126TH Ave NW
Coon Rapids, MN 55448-2512
Phone (651) 336-9254
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11225 Ulysses St NE
Blaine, MN 55434-4261
Phone (763) 302-2600
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| St. Croix Orthopaedics, PA | Past | Accepting new patients |
Locations
11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
Organizations & group practices 12
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
dba Fairview Clinics-Hiawatha
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
dba Fairview Clinics-Maple Grove
- Multi-Specialty Clinic/Center
- Maple Grove, MN
- NPI 1841315165
-
dba M Health Fairview Masonic Institute for the Developing Brain Clinic
- Clinic/Center
- Minneapolis, MN
- NPI 1023783198
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- Hospitalist Physician
- Burnsville, MN
- NPI 1952499444
-
- Durable Medical Equipment & Medical Supplies
- Hudson, WI
- NPI 1568840916
-
- Specialist
- Oak Park Heights, MN
- NPI 1255337945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1528353711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2355 126TH AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554482512",
"telephone_number": "651-336-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8232 HIGHWAY 65 NE",
"city": "SPRING LAKE PARK",
"state": "MN",
"postal_code": "554322095",
"telephone_number": "763-577-1877",
"fax_number": "763-577-1887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANKRATZ",
"first_name": "SHAUNA",
"middle_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spring Lake Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.