Peter John Lindbloom, PA C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9314 Issued in MN

Practice address

200 Elm St N
Onamia, MN 56359-7901

Phone

(320) 532-3154

Fax

(320) 532-3111

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

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.

• Glacial Ridge Hospital District

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment Care Compare group NPD MN
• Glacial Ridge Hospital District

  • Rural Health Clinic/Center
  • Starbuck, MN
  • NPI 1063952026
  Care Compare group NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Care Compare group NPD
• Glacial Ridge Hospital District

  • Home Health Agency
  • Glenwood, MN
  • NPI 1922017052
  Care Compare group NPD (past)
• Glacial Ridge Hospital District

  • Community Based Hospice Care Agency
  • Glenwood, MN
  • NPI 1134134877
  Care Compare group
• Glacial Ridge Hospital District

  • Family Medicine Physician
  • Glenwood, MN
  • NPI 1649285172
  Care Compare group
• Glacial Ridge Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Glenwood, MN
  • NPI 1649319146
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Care Compare affiliation Hospital

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glacial Ridge Hospital District 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glacial Ridge Hospital Hospital, Glenwood, MN, CCN 241376

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 15, 2013.

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1912970708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBLOOM",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "9314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ISLE",
            "identifier": "01-19641",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP23883",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "551295600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ONAMIA",
            "identifier": "01-13520",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9091033077",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CHAMPUS",
            "identifier": "410785161002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "562S8LI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "142458",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18358",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lou Larson, RN
• Johanna B Larson, RD
• Laura Lee, RN
• Sandra Jane Leo, PHARMD
• Kim Jo Leschak, LPN
• Nicole Loxterkamp, APRN, NP-C
• Mark Duane Marshall, PA
• Kayla Jo Meehan, PAC
• Memengwaa Psychotherapy
• Mary Kay Mercado, RN

• All providers in Onamia, MN
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.