NPIMap

Individual provider Active NPI

Catherine Pandiscio, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1871522599
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10060 Issued in MN
Practice address
9555 Upland LN N
Maple Grove, MN 55369-4485
Phone
(952) 831-8742
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10060 MN
Physician Assistant 363A00000X 10060 MN Primary

Addresses

Primary practice location

9555 Upland LN N
Maple Grove, MN 55369-4485

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

913 E 26th St
600
Minneapolis, MN 55404-4515
Phone (612) 775-6200

Other practice location 2

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Other identifiers 1

IdentifierTypeStateIssuer
682432300MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpandiscio87364@excellian.direct.allina.com Direct

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
I20051115000290 MN Practitioner - Physician Assistant 7719906270 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 1, 2014 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince May 6, 2024 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince May 6, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince May 6, 2024 Accepting new patients
Allina Health System CurrentSince Dec 1, 2014 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

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

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

913 E 26th St
#600
Minneapolis, MN 55404
Phone (612) 775-6154

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

Interoperability endpoints

  • Direct secure messaging: catherine.pandiscio.p2@direct.tcspine.nextgenshare.com

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 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1871522599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 UPLAND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694485",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 E 26th St",
            "address_2": "600",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044515",
            "country_code": "US",
            "telephone_number": "612-775-6200",
            "fax_number": "612-775-6222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8100 Northland Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554314800",
            "country_code": "US",
            "telephone_number": "952-831-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDISCIO",
        "first_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "10060",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682432300",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpandiscio87364@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "913 E 26th St",
            "address_2": "600",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.