Vikisha A Goberdhan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10524 Issued in MN

Practice address

4729 County Road 101
Minnetonka, MN 55345-2634

Phone

(952) 974-3200

NPI assigned

Jan 30, 2009

Last updated

Jan 30, 2009By the provider in NPPES

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

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

Philadelphia College of Osteopathic Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vgoberdhan258337@fairview.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  dba Fairview Clinics-Apple Valley

  • Primary Care Clinic/Center
  • Apple Valley, MN
  • NPI 1649462508
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  dba University of Minnesota Physicians Heart at Fairview

  • Cardiovascular Disease Physician
  • Burnsville, MN
  • NPI 1891930442
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  • Hospitalist Physician
  • Burnsville, MN
  • NPI 1952499444
  NPD
• Fairview Clinics

  dba Fairview Clinics-New Brighton

  • Primary Care Clinic/Center
  • New Brighton, MN
  • NPI 1881673002
  NPD (past)
• Fairview Express Care

  dba Institute for Athletic Medicine

  • Physical Therapy Clinic/Center
  • Minneapolis, MN
  • NPI 1407834302
  NPD (past)

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

• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1225199128
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Ridges Hospital

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  Care Compare affiliation

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1568600484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452634",
            "telephone_number": "952-974-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4729 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452634",
            "telephone_number": "952-974-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBERDHAN",
        "first_name": "VIKISHA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Glover, LAMFT
• Rachael Glover
• Michael Gmitro, MD
• Alannah J Gnirk, PT, DPT
• Nballu Goba, FNP
• Elizabeth Godes
• Holly J Godfrey, OT
• Madeline Streitz Pokorney Goeden, M.D.
• Maria Kristine Goertz, M.D.
• Cheryl Denise Goff, CRNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.