Individual provider Active NPI

Laura Elizabeth Willson, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1700198199
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1437 Issued in MN
Practice address
1536 Hewitt Ave # Ms -C1908
Saint Paul, MN 55104-1284
Phone
(651) 523-2204
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 1437 MN Primary

Addresses

Primary practice location

1536 Hewitt Ave # Ms -C1908
Saint Paul, MN 55104-1284

Mailing address

1930 Grand Ave
Saint Paul, MN 55105-1409
Phone (612) 799-9797

Other practice location 1

14655 Galaxie Ave
Apple Valley, MN 55124-8575
Phone (952) 432-6161

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
I20110523000607 MN Practitioner - Physician Assistant 5294911400 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1875 Woodwinds Dr
Woodbury, MN 55125-2298
Phone (651) 232-6800

1925 Woodwinds Dr
Woodbury, MN 55125-4445
Phone (651) 232-0100

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1437MNMDPhysician Assistant
10826MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Nov 29, 2021 Accepting new patients
Fairview Express Care CurrentSince Nov 29, 2021 Accepting new patients
Fairview Clinics CurrentSince Nov 29, 2021 Accepting new patients
Fairview Health Services CurrentSince Nov 29, 2021 Accepting new patients
Fairview Health Services CurrentSince Nov 29, 2021 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Nov 29, 2021 Accepting new patients
Fairview Clinics CurrentSince Nov 29, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

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

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

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

3305 Central Park Village Dr
#200
Saint Paul, MN 55121

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1700198199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051409",
            "telephone_number": "612-799-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 HEWITT AVE # MS -C1908",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041284",
            "telephone_number": "651-523-2204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14655 Galaxie Ave",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551248575",
            "country_code": "US",
            "telephone_number": "952-432-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.