NPIMap

Individual provider Active NPI

Sophia Lynn Hanson, PA

  • Physician Assistant
  • Andover, MN
National Provider Identifier
1689303802
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14727 Issued in MN
Practice address
15245 Bluebird St NW
Andover, MN 55304-3538
Phone
(763) 587-4688
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 14727 MN Primary

Addresses

Primary practice location

15245 Bluebird St NW
Andover, MN 55304-3538

Mailing address

8366 Fairchild Ave
Saint Paul, MN 55112-6121
Phone (763) 248-6378

Other practice location 1

530 3rd St NW
Elk River, MN 55330-1445
Phone (763) 587-4688

Other practice location 2

2621 Greenhaven Rd
Anoka, MN 55303-5566
Phone (763) 587-4688

Other practice location 3

8366 Fairchild Ave
Saint Paul, MN 55112-6121
Phone (763) 248-6378

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
I20240514001327 MN Practitioner - Physician Assistant 1254772825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15245 Bluebird NWST
Andover, MN 55304-3554
Phone (763) 712-6000

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Mar 6, 2024 Accepting new patients
Group Health, Inc. CurrentSince Mar 6, 2024 Accepting new patients

Locations

15245 Bluebird St NW
Anoka, MN 55304
Phone (763) 587-4600

2621 Greenhaven Rd
Anoka, MN 55303
Phone (763) 587-4400

530 3rd St NW
Elk River, MN 55330
Phone (763) 587-4800

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1689303802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8366 FAIRCHILD AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551126121",
            "telephone_number": "763-248-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043538",
            "telephone_number": "763-587-4688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 3rd St NW",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553301445",
            "country_code": "US",
            "telephone_number": "763-587-4688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2621 Greenhaven Rd",
            "address_purpose": "LOCATION",
            "city": "Anoka",
            "state": "MN",
            "postal_code": "553035566",
            "country_code": "US",
            "telephone_number": "763-587-4688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8366 Fairchild Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551126121",
            "country_code": "US",
            "telephone_number": "763-248-6378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "SOPHIA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.