NPIMap

Individual provider Active NPI

Elena M Puig-Wong, PA-C

  • Medical Physician Assistant
  • Edina, MN
National Provider Identifier
1982036463
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
12752 Issued in MN
Practice address
3400 W 66TH St Ste 150
Edina, MN 55435-2109
Phone
(952) 920-7200
Fax
(763) 302-4234
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 PA030946 DC
Medical Physician Assistant 363AM0700X 12752 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 150
Edina, MN 55435-2109

Mailing address

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (941) 400-3295

Other names 1

  • Elena Puig Other name

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
I20181003002396 MN Practitioner - Physician Assistant 4880973866 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12752MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians CurrentSince Mar 21, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Mar 21, 2022 Accepting new patients
Fairview Express Care CurrentSince Mar 21, 2022 Accepting new patients
Fairview Express Care CurrentSince Mar 21, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Mar 21, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

Interoperability endpoints

  • Direct secure messaging: epuigwong468201@fairview.direct-ci.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 5

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1982036463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "941-400-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 150",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352109",
            "telephone_number": "952-920-7200",
            "fax_number": "763-302-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUIG-WONG",
        "first_name": "ELENA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "PA030946",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "PUIG",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.