Individual provider Active NPI

Autumn Sue Ties, MD

  • Emergency Medicine Physician
  • Apple Valley, MN
National Provider Identifier
1871177501
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
74346 Issued in MN
Practice address
15350 English Ave
Apple Valley, MN 55124-6252
Phone
(952) 853-8800
NPI assigned
May 9, 2021
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 74346 MN Primary

Addresses

Primary practice location

15350 English Ave
Apple Valley, MN 55124-6252

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456

Other practice location 1

3930 Northwoods Dr
Arden Hills, MN 55112-6963
Phone (952) 853-8800

Other practice location 2

205 Wabasha St S
Saint Paul, MN 55107-1805
Phone (952) 853-8800

Other practice location 3

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (952) 853-8800

Other practice location 4

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (952) 853-8800

Other practice location 5

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone (952) 853-8800

Other names 1

  • Autumn Sue Pace Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127001517 MN Practitioner - Emergency Medicine 4789079492 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Nov 1, 2023 Accepting new patients
Regions Hospital Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Minnesota Valley Health Center Inc Current Accepting new patients
Sibley Medical Center CurrentSince Sep 1, 2024 Accepting new patients
Ridgeview Medical Center CurrentSince Sep 1, 2024 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2024 Accepting new patients

Locations

15350 English Ave
Apple Valley, MN 55124
Phone (952) 431-8500

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

1500 Curve Crest Blvd W
Stillwater, MN 55082

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1620518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1871177501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 ENGLISH AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246252",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3930 Northwoods Dr",
            "address_purpose": "LOCATION",
            "city": "Arden Hills",
            "state": "MN",
            "postal_code": "551126963",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Wabasha St S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551071805",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Como Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551081460",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8450 Seasons Pkwy",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551254402",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Curve Crest Blvd W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826040",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIES",
        "first_name": "AUTUMN",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-09",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "74346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "PACE",
            "middle_name": "SUE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.