Soaly Pin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4365 Pheasant Ridge Dr NE Ste 106
Blaine, MN 55449-4544

Phone

(888) 938-3838

Fax

(888) 919-1083

NPI assigned

Apr 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Institutes LLCGroup PAC ID 4880928761, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ear Institutes, LLC

  • Otolaryngology Physician
  • Blaine, MN
  • NPI 1881168441
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1982286019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 PHEASANT RIDGE DR NE STE 106",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494544",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIN",
        "first_name": "SOALY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MINNEAPOLIS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2893 Knox Ave S Apt 311",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554081860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Uyen Pham
• Erica D Phillips
• Phoenixbird Transportation Inc
• Piic Clinical Services
• Amanda Lucy Pikala, LMFT
• Brian Pisarcik
• Cynthia Marie Polk, REGISTERED NURSE
• Tanager Yvonne Polowchak, MA, LPCC
• Autumn Rose Popowski
• Gregory John Povolny, D.D.S.

• Physician Assistant in Blaine, MN
• Providers in Blaine, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.