NPIMap

Individual provider Active NPI

Lisa Elizabeth Worthington, PA-C

  • Physician Assistant
  • Edina, MN
National Provider Identifier
1992174007
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14025 Issued in MN
Practice address
6401 France Ave S
Edina, MN 55435
Phone
(952) 924-5000
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60892491 WA
Physician Assistant 363A00000X 14025 MN Primary

Addresses

Primary practice location

6401 France Ave S
Edina, MN 55435

Mailing address

4015 County Road 25 Apt 320
Saint Louis Park, MN 55416-3495

Other practice location 1

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

Other practice location 2

914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 827-8811

Other names 1

  • Lisa Elizabeth Carroll Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lcarroll975243@wm.providencedirect.org Direct

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
I20220517000909 MN Practitioner - Physician Assistant 4981901246 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

6405 France Ave S
Suite W300
Edina, MN 55435-2163
Phone (952) 929-6994

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14025MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Sep 7, 2022 Accepting new patients
Fairview Clinics CurrentSince Sep 7, 2022 Accepting new patients
Fairview Health Services CurrentSince May 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Sep 7, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2023 Accepting new patients
Fairview Health Services CurrentSince May 1, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Sep 7, 2022 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 12

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 3

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1992174007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 COUNTY ROAD 25 APT 320",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554163495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-672-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 S Scheuber Rd",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985319027",
            "country_code": "US",
            "telephone_number": "360-827-8811",
            "fax_number": "360-330-8969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "LISA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60892491",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcarroll975243@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "914 S Scheuber Rd",
            "city": "Centralia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985319027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CARROLL",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.