Individual provider Active NPI

Eric Andrew Smith, PA

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1598199366
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1969 Issued in MN
Practice address
2610 Central Ave NE
Minneapolis, MN 55418-2911
Phone
(612) 781-6816
NPI assigned
Aug 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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 1969 MN Primary

Addresses

Primary practice location

2610 Central Ave NE
Minneapolis, MN 55418-2911

Mailing address

2301 Central Ave NE
Minneapolis, MN 55418-3709
Phone (612) 287-2429

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
I20140917001808 MN Practitioner - Physician Assistant 6709005101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

1009 E 14TH St
Minneapolis, MN 55404-1314
Phone (612) 348-5553

1010 Currie Ave
Minneapolis, MN 55403-1309
Phone (612) 348-5553

2740 1St Ave S
Minneapolis, MN 55408-1611
Phone (612) 348-5553

Hospital & facility affiliations

  • Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1969MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Nov 4, 2024 Accepting new patients
Hennepin County CurrentSince Nov 4, 2024 Accepting new patients
Hennepin County Past Accepting new patients

Locations

525 Portland Ave
Minneapolis, MN 55415
Phone (612) 348-8824

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1598199366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183709",
            "telephone_number": "612-287-2429",
            "fax_number": "612-781-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554182911",
            "telephone_number": "612-781-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIC",
        "middle_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.