Individual provider Active NPI

Erik L. Haltson, PA-C

  • Physician Assistant
  • St Louis Park, MN
National Provider Identifier
1730311887
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10654 Issued in MN
Practice address
1665 Utica Ave S Ste 100
St Louis Park, MN 55416-3476
Phone
(952) 541-2500
Fax
(952) 541-2539
NPI assigned
Aug 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 10654 MN Primary

Addresses

Primary practice location

1665 Utica Ave S Ste 100
St Louis Park, MN 55416-3476

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

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
I20100121000017 MN Practitioner - Physician Assistant 1254473895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
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)

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 Oct 4, 2010 Accepting new patients
Group Health, Inc. CurrentSince Oct 4, 2010 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 5, 2016 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

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

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

8170 33rd Ave S
Stop 21110
Minneapolis, MN 55425

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

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

2001 Blaisdell Ave
Minneapolis, MN 55404
Phone (952) 993-8000

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

1665 Utica Ave S
Ste 100
St Louis Park, MN 55416
Phone (952) 541-2500

1500 Curve Crest Blvd W
Stillwater, MN 55082

Organizations & group practices 5

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": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1730311887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 UTICA AVE S STE 100",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163476",
            "telephone_number": "952-541-2500",
            "fax_number": "952-541-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTSON",
        "first_name": "ERIK",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.