Individual provider Active NPI

Erik Haakon Grindal, PA-C

  • Physician Assistant
  • Apple Valley, MN
National Provider Identifier
1578085742
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12447 Issued in MN
Practice address
15051 Galaxie Ave
Apple Valley, MN 55124-6987
Phone
(952) 432-3535
NPI assigned
Jul 10, 2017
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12447 MN Primary

Addresses

Primary practice location

15051 Galaxie Ave
Apple Valley, MN 55124-6987

Mailing address

15051 Galaxie Ave
Apple Valley, MN 55124-6987

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170906000050 MN Practitioner - Physician Assistant 4789957200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

1010 W Lake St
Minneapolis, MN 55408-2883
Phone (866) 389-2727

1040 Grand Ave
Saint Paul, MN 55105-3001
Phone (866) 389-2727

1500 109TH Ave NE
Blaine, MN 55449-4670
Phone (866) 389-2727

15051 Galaxie Ave
Apple Valley, MN 55124-6987
Phone (866) 389-2727

4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Phone (866) 389-2727

6905 York Ave S
Edina, MN 55435-2517
Phone (866) 389-2727

8251 Columbine Rd
Eden Prairie, MN 55344-7610
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1578085742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15051 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15051 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246987",
            "telephone_number": "952-432-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDAL",
        "first_name": "ERIK",
        "middle_name": "HAAKON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.