Individual provider Active NPI

Cole Benjamin Smith, PA-C

  • Physician Assistant
  • Oak Park Heights, MN
National Provider Identifier
1871200329
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14246 Issued in MN
Practice address
5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone
(514) 398-8076
Fax
(651) 439-0232
NPI assigned
Nov 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8071-23 WI
Physician Assistant 363A00000X 14246 MN Primary

Addresses

Primary practice location

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230120001598 MN Practitioner - Physician Assistant 7113398652 Reassigns benefits to 3 organizations
I20240916000909 WI Practitioner - Physician Assistant 7113398652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

2211 Vine St
Hudson, WI 54016-1899
Phone (715) 386-1155

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

5130 Fairview Blvd
Suite 100
Wyoming, MN 55092-8050
Phone (651) 439-8807

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8071-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Feb 1, 2023 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Oct 14, 2024 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Oct 14, 2024 Accepting new patients
Group Health, Inc. Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

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

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

3545 Highway 61 N
Vadnais Heights, MN 55110

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

5130 Fairview Blvd
Ste 100
Wyoming, MN 55092

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

Organizations & group practices 9

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 1

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1871200329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 MEMORIAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550821093",
            "telephone_number": "514-398-8076",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COLE",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8071-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park Heights, MN

Sources for this page

Verify at the official NPI Registry.