Active NPI
Lauren Elizabeth Mittlestadt, PA-C
- Physician Assistant
- Saint Paul, MN
National Provider Identifier
1811600067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15942
- Practice address
- 295 Phalen Blvd
Saint Paul, MN 55130-2455 - Phone
- (651) 495-6200
- NPI assigned
- Jan 3, 2023
- Last updated
- Oct 6, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15942 | MN | Primary |
Addresses
Primary practice location
295 Phalen Blvd
Saint Paul, MN 55130-2455
Mailing address
295 Phalen Blvd
Saint Paul, MN 55130-2455
Phone (651) 495-6200
Other practice location 1
640 Jackson St
Saint Paul, MN 55101-2595
Phone (651) 254-3456
Other practice location 2
6500 Excelsior Blvd
St Louis Park, MN 55426-4700
Phone (952) 993-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791244800000",
"number": "1811600067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 PHALEN BLVD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551302455",
"telephone_number": "651-495-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 PHALEN BLVD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551302455",
"telephone_number": "651-495-6200"
}
],
"practiceLocations": [
{
"address_1": "640 Jackson St",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551012595",
"country_code": "US",
"telephone_number": "651-254-3456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6500 Excelsior Blvd",
"address_purpose": "LOCATION",
"city": "St Louis Park",
"state": "MN",
"postal_code": "554264700",
"country_code": "US",
"telephone_number": "952-993-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITTLESTADT",
"first_name": "LAUREN",
"middle_name": "ELIZABETH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-03",
"last_updated": "2026-10-06",
"certification_date": "2026-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "15942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.