PEDIATRIC AND YOUNG ADULT MEDICINE, PA (NPI# 1457593550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457593550 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC AND YOUNG ADULT MEDICINE, PA |
| Practice Address |
8650 Hudson Blvd N Suite 125 Lake Elmo MN 55042-9747 |
| Mailing Address |
1804 7th St W Suite 200 Saint Paul MN 55116-2300 |
| Practice Telephone | 6512566706 |
| Practice Fax Number | 6512566707 |
| Mailing Telephone | 6512566706 |
| Mailing Fax Number | 6512566707 |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2016-12-07 |
| Authorized Official Name | MS. TERRI M JOSEPH (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 6512566706 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
154 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1245210095 | 05 | |
| MN | 1861558835 | 05 | |
| MN | 1881057065 | 05 | |
| MN | 1083694046 | 05 | |
| MN | 1245210210 | 05 | |
| MN | 1386991339 | 05 | |
| MN | 1497735419 | 05 | |
| MN | 1912987900 | 05 | |
| MN | 1477870921 | 05 | |
| MN | 1104806165 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710129812 | Pediatric and Young Adult Medicine, Pa | Clinic/Center | 1610 Maxwell Dr, Suite 245, Hudson, WI 54016-8709 | 2009-04-03 |
| 1205078300 | Pediatric and Young Adult Medicine, Pa | Clinic/Center | 3470 Washington Dr, Suite 201, Eagan, MN 55122-1355 | 2009-04-03 |
| 1295977395 | Pediatric and Young Adult Medicine, Pa | Clinic/Center | 1655 Beam Ave, Suite 108, Maplewood, MN 55109-1163 | 2009-04-03 |
| 1932316916 | Pediatric and Young Adult Medicine, Pa | Clinic/Center | 1804 7th St W, Suite 200, Saint Paul, MN 55116-2300 | 2007-05-17 |
| Street Address |
8650 HUDSON BLVD N SUITE 125 |
| City | LAKE ELMO |
| State | MN |
| Zip Code | 55042-9747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805278 | East Metro Asc LLC | Clinic/Center | 8650 Hudson Blvd N, Lake Elmo, MN 55042-8448 | 2005-07-19 |
| 1396120473 | Pdg, Pa | Clinic/Center | 8650 Hudson Blvd N, Suite 105, Lake Elmo, MN 55042 | 2015-07-30 |
| 1932587383 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 8650 Hudson Blvd N, Suite 100, Lake Elmo, MN 55042-9747 | 2015-05-18 |
| 1003212176 | Michelle Cunningham | Nurse Anesthetist, Certified Registered | 8650 Hudson Blvd N, Suite 235, Lake Elmo, MN 55042-9747 | 2014-11-17 |
| 1558648337 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 8650 Hudson Blvd N, Ste. 100, Lake Elmo, MN 55042-9747 | 2011-11-08 |
| 1497072680 | Patricia Akers | Nurse Anesthetist, Certified Registered | 8650 Hudson Blvd N, Suite 235, Lake Elmo, MN 55042-9747 | 2010-04-27 |
| 1326178948 | Lakeview Hospital Inc. | Pharmacy | 8650 Hudson Blvd N, Suite 100, Lake Elmo, MN 55042-9747 | 2007-03-06 |
| 1982763454 | Alfredo Montes Imeri | Dentist | 8650 Hudson Blvd N, #105, Lake Elmo, MN 55042-9747 | 2006-12-08 |
| 1407915432 | John Clayton Withrow | Dentist | 8650 Hudson Blvd N, Suite105, Lake Elmo, MN 55042-9747 | 2006-12-06 |
| 1598824583 | Bruce Douglas Campbell | Dentist | 8650 Hudson Blvd N, Suite 105, Lake Elmo, MN 55042-9747 | 2006-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811440738 | Eleni Voltidi | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2016-07-27 |
| 1760781314 | Swedehill Lifecare, LLC | Home Health | 8951 Highway 5, Lake Elmo, MN 55042 | 2011-03-22 |
| 1295859676 | St Croix Valley Dental Pllc | Dentist | 10035 City Walk Dr, Ste A Lake Elmo Dental, Lake Elmo, MN 55042 | 2007-03-19 |
| 1245281823 | Kent Gregory Brockmann | Psychiatry & Neurology | 8673 Eagle Point Blvd, Lake Elmo, MN 55042 | 2006-05-16 |
| 1396722674 | Nancy L Johnson-rauen | Physical Therapist | 9242 Hudson Blvd N Ste 400, Lake Elmo, MN 55042 | 2005-12-28 |
| 1639655384 | Katlyn Arndt | Psychiatry & Neurology | 8515 Eagle Point Blvd, Lake Elmo, MN 55042 | 2018-07-16 |
| 1295227247 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2018-06-05 |
| 1124455324 | Leslie Markowitz | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2013-10-02 |
| 1215295001 | Jessica R Baltz | Marriage & Family Therapist | 3819 Laverne Ave N, Lake Elmo, MN 55042 | 2012-04-30 |
| 1790053460 | Jennifer Jean Solin | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2011-12-08 |
| Find all providers in zip 55042 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423252 | Good Clinic Mn Pllc | Clinic/Center | 315 1st Ave Ne, Minneapolis, MN 55413-5001 | 2020-09-30 |
| 1407496219 | Hope Health Initiative | Clinic/Center | 6818 Humboldt Ave N, Brooklyn Center, MN 55430-1536 | 2020-01-09 |
| 1902392525 | Odam Medical Group | Clinic/Center | 3405 3rd St N, Saint Cloud, MN 56303-4015 | 2018-07-06 |
| 1376041822 | Piic Clinical Services | Clinic/Center | 6500 Humboldt Ave N, Brooklyn Center, MN 55430-1800 | 2018-01-30 |
| 1760905475 | Patient Centered Care | Clinic/Center | 8240 Hampshire Ct N, Brooklyn Park, MN 55445 | 2017-07-25 |
| 1740703339 | Neopath | Clinic/Center | 119 30th Ave W Ste 119, Alexandria, MN 56308-3433 | 2017-07-25 |
| 1720500309 | Centracare Clinic | Clinic/Center | 2749 Sexton Drive, Mary Hall - Room 001, Collegeville, MN 56321 | 2017-07-14 |
| 1881116747 | Centracare Clinic | Clinic/Center | 402 Red River Ave N Ste 2, Cold Spring, MN 56320-1523 | 2017-07-12 |
| 1558898387 | Centracare Clinic | Clinic/Center | 161 Glen St., Ste 101, Foley, MN 56329 | 2017-05-11 |
| 1164958104 | Centracare Clinic | Clinic/Center | 113 Waite Ave S Ste 101, Waite Park, MN 56387-1348 | 2017-05-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.