Individual provider Active NPI

Phillip James Craig, PA-C

  • Surgical Physician Assistant
  • Edina, MN
National Provider Identifier
1659340669
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9925 Issued in MN
Practice address
6405 France Ave S
#W440
Edina, MN 55435-2163
Phone
(952) 927-7004
Fax
(952) 927-5146
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9925 MN Primary

Addresses

Primary practice location

6405 France Ave S
#W440
Edina, MN 55435-2163

Mailing address

3400 W 66TH St
Suite 350
Edina, MN 55435-2111
Phone (952) 832-0805

Other identifiers 1

IdentifierTypeStateIssuer
377115600MedicaidMN

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
I20050103000798 MN Practitioner - Physician Assistant 9133187495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6405 France Ave S
Suite W440
Edina, MN 55435-2190
Phone (952) 927-7004

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Oct 13, 2024 Accepting new patients
Fairview Health Services CurrentSince Oct 1, 2008 Accepting new patients
Fairview Express Care CurrentSince Oct 13, 2024 Accepting new patients
Fairview Health Services CurrentSince Oct 1, 2008 Accepting new patients
Fairview Health Services Past Accepting new patients
Surgical Consultants, P.a. Past Accepting new patients

Locations

303 E Nicollet Blvd
Ste 300
Burnsville, MN 55337
Phone (952) 435-4140

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

6405 France Ave S
Ste 440
Edina, MN 55435
Phone (952) 927-7004

6405 France Ave S
Ste W440
Edina, MN 55435
Phone (952) 345-4178

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

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: pcraig147546@fairview.direct-ci.com

Organizations & group practices 7

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1659340669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST",
            "address_2": "SUITE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352111",
            "telephone_number": "952-832-0805",
            "fax_number": "952-832-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S",
            "address_2": "#W440",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352163",
            "telephone_number": "952-927-7004",
            "fax_number": "952-927-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "PHILLIP",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "9925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377115600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.