Individual provider Active NPI

Laura M Pothast, PA

  • Physician Assistant
  • New Hope, MN
National Provider Identifier
1750890281
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14182 Issued in MN
Practice address
8100 42ND Ave N
New Hope, MN 55427-1107
Phone
(762) 581-5700
NPI assigned
Sep 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14182 MN Primary
Physician Assistant 363A00000X 4211-23 WI

Addresses

Primary practice location

8100 42ND Ave N
New Hope, MN 55427-1107

Mailing address

1240 S 2ND St Unit 106
Minneapolis, MN 55415-2603
Phone (952) 239-7980

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
I20221011001915 MN Practitioner - Physician Assistant 9537435896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

15450 Hwy 7
Minnetonka, MN 55345-3522

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

4209 Webber Pkwy
Minneapolis, MN 55412-1747
Phone (763) 581-2273

8100 42ND Ave N
New Hope, MN 55427-1107
Phone (763) 581-2273

8301 Golden Valley Rd
Suite 100
Golden Valley, MN 55427-4469
Phone (763) 581-2273

8559 Edinbrook Pkwy
Suite 100
Brooklyn Park, MN 55443-3728
Phone (763) 581-2273

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14182MNMDPhysician Assistant
4211-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Oct 15, 2022 Accepting new patients
North Memorial Health Care CurrentSince Oct 15, 2022 Accepting new patients

Locations

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

8100 42nd Ave N
New Hope, MN 55427
Phone (763) 581-5700

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

Interoperability endpoints

  • Direct secure messaging: ljacobson192490@direct.northmemorial.com

Organizations & group practices 2

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1750890281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S 2ND ST UNIT 106",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554152603",
            "telephone_number": "952-239-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 42ND AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554271107",
            "telephone_number": "762-581-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHAST",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14182",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4211-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hope, MN

Sources for this page

Verify at the official NPI Registry.