Julie Elizabeth Ewasiuk, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18782 Issued in MN

Practice address

111 Hudertmark Road
Suite 210
Chaska, MN 55318

Phone

(952) 401-8300

Fax

(952) 401-8242

NPI assigned

Jun 26, 2007

Last updated

Dec 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Julie Milne Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

University of Minnesota Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Lake Clinic PAGroup PAC ID 3173500303, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• South Lake Clinic, P.a.

  dba South Lake Pediatrics

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1427027184
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1740486687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DRIVE",
            "address_2": "SUITE 250",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-401-8300",
            "fax_number": "952-401-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUDERTMARK ROAD",
            "address_2": "SUITE 210",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "55318",
            "telephone_number": "952-401-8300",
            "fax_number": "952-401-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWASIUK",
        "first_name": "JULIE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "18782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MILNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Marie Erdmann, DPT
• Kristine Maria Erickson, LICSW
• Laurel L Erickson, M.D.
• David Erlandson, DPT
• Stephanie Ess, MA, LMFT
• Eyewearspecialists
• Fabian Homecare LLC
• Colleen Fafinski, LP
• Fairview Express Care
• Family Therapy Specialists, Inc (Family Therapy Specialists)

• Pediatrics Physician in Chaska, MN
• Providers in Chaska, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.