Active NPI
Soaly Pin, PA-C
- Physician Assistant
- Blaine, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- 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
- Last updated
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4365 Pheasant Ridge Dr NE Ste 106
Blaine, MN 55449-4544
Mailing address
10001 W Innovation Dr Ste 200
Milwaukee, WI 53226-4851
Phone (888) 938-3838
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MINNEAPOLIS | Direct |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4365 Pheasant Ridge Dr NE
Suite 106
Blaine, MN 55449-4544
Phone (888) 938-3838
6640 Shady Oak Rd
Suite 255
Eden Prairie, MN 55344-7710
Phone (888) 938-3838
8401 Seasons Pkwy
Suite 300
Woodbury, MN 55125-3476
Phone (888) 938-3838
9325 Upland LN N
Suite 200
Maple Grove, MN 55369-4443
Phone (888) 938-3838
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13877 | MN | MD | Physical Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
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": []
}
Other providers in Blaine, MN
Sources for this page
- 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.