Individual provider Active NPI

Emily Elizabeth Greene, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1629241773
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
363A00000X Issued in MN
Practice address
2155 Ford Pkwy
Saint Paul, MN 55116-1862
Phone
(651) 696-5000
NPI assigned
Apr 9, 2008
Last updated
Nov 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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 363A00000X MN Primary

Addresses

Primary practice location

2155 Ford Pkwy
Saint Paul, MN 55116-1862

Mailing address

2724 Emerson Ave S
Minneapolis, MN 55408-1232
Phone (612) 868-5041

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
I20081106000577 MN Practitioner - Physician Assistant 3779642640 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
363A00000XMNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Aug 28, 2010 Accepting new patients
Fairview Clinics CurrentSince Aug 28, 2010 Accepting new patients
Fairview Health Services CurrentSince Aug 28, 2010 Accepting new patients
Group Health, Inc. CurrentSince Aug 9, 2021 Accepting new patients
Fairview Health Services CurrentSince Aug 28, 2010 Accepting new patients
Fairview Express Care CurrentSince Mar 24, 2009 Accepting new patients
Group Health, Inc. CurrentSince Aug 9, 2021 Accepting new patients
Fairview Express Care CurrentSince Mar 24, 2009 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 586
Edina, MN 55435
Phone (952) 915-8770

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

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

4000 Central Ave NE
Saint Anthony, MN 55421
Phone (763) 572-5700

1151 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (612) 706-4500

2155 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

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.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1629241773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 EMERSON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081232",
            "telephone_number": "612-868-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161862",
            "telephone_number": "651-696-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "363A00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.