NPIMap

Individual provider Active NPI

Amy Lynn Gerlach, PA-C

  • Medical Physician Assistant
  • Columbia Heights, MN
National Provider Identifier
1770733883
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11032 Issued in MN
Practice address
4000 Central Ave NE
Columbia Heights, MN 55421-2968
Phone
(763) 782-8183
Fax
(763) 782-8100
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 11032 MN Primary

Addresses

Primary practice location

4000 Central Ave NE
Columbia Heights, MN 55421-2968

Mailing address

4000 Central Ave NE
Columbia Heights, MN 55421-2968
Phone (763) 782-8183

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
I20120321000911 MN Practitioner - Physician Assistant 5799838017 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

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

6341 University Ave NE
Fridley, MN 55432-4946
Phone (763) 572-5700

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

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11032MNMDDentist
4257AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Mar 25, 2021 Accepting new patients
Fairview Express Care CurrentSince Mar 25, 2021 Accepting new patients
Fairview Health Services CurrentSince Mar 9, 2012 Accepting new patients
Fairview Clinics CurrentSince Nov 15, 2012 Accepting new patients
Fairview Clinics CurrentSince Nov 15, 2012 Accepting new patients
Fairview Health Services CurrentSince Mar 9, 2012 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

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

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

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

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

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

4000 Central Ave NE
Saint Anthony, MN 55421
Phone (763) 572-5700

Interoperability endpoints

  • Direct secure messaging: agerlach259807@fairview.direct-ci.com

Organizations & group practices 10

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1770733883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL AVE NE",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554212968",
            "telephone_number": "763-782-8183",
            "fax_number": "763-782-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL AVE NE",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554212968",
            "telephone_number": "763-782-8183",
            "fax_number": "763-782-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLACH",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "11032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia Heights, MN

Sources for this page

Verify at the official NPI Registry.