NPIMap

Individual provider Active NPI

Rachel Lynn Enge, PA-C

  • Physician Assistant
  • Blaine, MN
National Provider Identifier
1861787343
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11855 Ulysses Street NE
Blaine, MN 55434
Phone
(763) 785-4500
NPI assigned
Jun 13, 2011
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

11855 Ulysses Street NE
Blaine, MN 55434

Mailing address

11855 Ulysses Street NE
Blaine, MN 55434
Phone (763) 785-4500

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
I20110802000704 MN Practitioner - Physician Assistant 7416126719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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)

2600 39TH Ave NE
Minneapolis, MN 55421-4379
Phone (651) 430-3800

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

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (651) 430-3800

480 Osborne Rd NE
Suite 100
Fridley, MN 55432-2781
Phone (763) 581-2273

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10915MNMDPhysical Therapist
1567MNMDPulmonary Rehabilitation Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Jul 1, 2017 Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2017 Accepting new patients

Locations

11855 Ulysses St NE
Ste 110
Blaine, MN 55434
Phone (763) 235-4104

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

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

480 Osborne Rd NE
Ste 100
Minneapolis, MN 55432
Phone (763) 785-4500

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

1835 County Road C W
Saint Paul, MN 55113
Phone (651) 638-0080

Interoperability endpoints

  • Direct secure messaging: renge127922@direct.northmemorial.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1861787343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES STREET NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-785-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES STREET NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-785-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGE",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.