Individual provider Active NPI

Precious Audrey Gbagba

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1861182016
Registry record updated Feb 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1527 E Lake St Ste 1
Minneapolis, MN 55407-6700
Phone
(612) 345-7175
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1527 E Lake St Ste 1
Minneapolis, MN 55407-6700

Mailing address

1527 E Lake St Ste 1
Minneapolis, MN 55407-6700

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
I20260413000993 MN Practitioner - Physician Assistant 4880169341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trucare Urgent Care LLCGroup PAC ID 6709253990, 3 clinicians
Trucare Clinic LLCGroup PAC ID 6901274604, 2 clinicians

Practice addresses (Care Compare)

1527 E Lake St
Minneapolis, MN 55407-6700
Phone (612) 345-7175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trucare Urgent Care LLC CurrentSince Jan 31, 2026 Accepting new patients
Trucare Clinic LLC CurrentSince Jan 31, 2026 Accepting new patients

Locations

1527 E Lake St
Minneapolis, MN 55407
Phone (612) 345-7175

1527 E Lake St
Ste 1
Minneapolis, MN 55407
Phone (612) 345-7175

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEFHCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1861182016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 E LAKE ST STE 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554076700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 E LAKE ST STE 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554076700",
            "telephone_number": "612-345-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GBAGBA",
        "first_name": "PRECIOUS",
        "middle_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.