NPIMap

Individual provider Active NPI

Mary Kathleen Pugh Hjelm, PA-C

  • Surgical Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1578227211
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
13987 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 336-2727
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 13987 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

909 Fulton St SE
Minneapolis, MN 55455-4800

Other names 1

  • Mary Kathleen Pugh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513001486 MN Practitioner - Physician Assistant 3173900024 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jul 1, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 1, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2022 Accepting new patients

Locations

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

Interoperability endpoints

  • Direct secure messaging: mhjelm726406@fairview.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1578227211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-336-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HJELM",
        "first_name": "MARY",
        "middle_name": "KATHLEEN PUGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "13987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PUGH",
            "middle_name": "KATHLEEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.