NPIMap

Individual provider Active NPI

Stephanie Linnea Peters, MS, PA-C

  • Physician Assistant
  • Edina, MN
National Provider Identifier
1760813570
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12562 Issued in MN
Practice address
6401 France Ave S Dept of
Edina, MN 55435-2104
Phone
(952) 924-5000
NPI assigned
Dec 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X CDR 997338
Physician Assistant 363A00000X 12562 MN Primary

Addresses

Primary practice location

6401 France Ave S Dept of
Edina, MN 55435-2104

Mailing address

6401 France Avenue South
Department of Medicine
Edina, MN 55435-2104
Phone (952) 924-5000

Other names 1

  • Stephanie Linnea Shaw Former name

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
I20180110002191 MN Practitioner - Physician Assistant 3072872480 Reassigns benefits to 2 organizations

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
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Dietitian, Registered CurrentSince Jan 12, 2018 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 6, 2023 Accepting new patients
Fairview Health Services CurrentSince Jan 12, 2018 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 6, 2023 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

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

Interoperability endpoints

  • Direct secure messaging: speters427775@fairview.direct-ci.com

Organizations & group practices 6

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1760813570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVENUE SOUTH",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S DEPT OF",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "STEPHANIE",
        "middle_name": "LINNEA",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "CDR 997338",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SHAW",
            "middle_name": "LINNEA",
            "credential": "MS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.