NPIMap

Individual provider Active NPI

Nicholas Elliott, M.D.

  • Urology Physician
  • Woodbury, MN
National Provider Identifier
1932640562
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
74318 Issued in MN
Practice address
6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone
(651) 999-6800
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 74318 MN Primary

Addresses

Primary practice location

6025 Lake Rd Ste 200
Woodbury, MN 55125-1710

Mailing address

6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone (651) 999-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230728000752 MN Practitioner - Urology 9931472420 Reassigns benefits to 2 organizations
I20240228004308 WI Practitioner - Urology 9931472420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians
Minnesota Urology, PAGroup PAC ID 0840183984, 83 clinicians

Practice addresses (Care Compare)

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1555

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

6025 Lake Rd
Suite 200
Woodbury, MN 55125-1710
Phone (651) 999-6800

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Western Wisconsin Health Hospital, Baldwin, WI, CCN 521347
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection22
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Medical Center Current Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Minnesota Urology, PA Urology CurrentSince Aug 1, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
St Joseph'S Medical Center CurrentSince Jun 28, 2024 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Mar 1, 2024 Accepting new patients
Metropolitan Urologic Specialists PA Urology Past Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

2945 Hazelwood St
Ste 220
Maplewood, MN 55109

3001 Metro Dr
Ste 460
Minneapolis, MN 55425
Phone (651) 999-7022

360 Sherman St
Ste 450
Saint Paul, MN 55102
Phone (651) 641-7100

6025 Lake Rd
Ste 200
Woodbury, MN 55125

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

Interoperability endpoints

  • Direct secure messaging: nicholas.elliott.1@20581.direct.athenahealth.com
  • Direct secure messaging: nelliott635258@excellian.direct.allina.com
  • Direct secure messaging: nelliott87608@direct.luhs.org
  • FHIR API: https://api.platform.athenahealth.com/20581/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 28

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

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1932640562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 LAKE RD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251710",
            "telephone_number": "651-999-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 LAKE RD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251710",
            "telephone_number": "651-999-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "74318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.