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ELIZA S DAHLY PA-C
NPI 1104755453
Physician Assistant in Blaine, MN

Active since May 14, 2026PECOS Enrolled
11225 ULYSSES ST NE, BLAINE, MN 55434(763) 302-2600 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eliza S Dahly Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZA S DAHLY PA-C (NPI 1104755453) is an individual physician assistant in Blaine, Minnesota, licensed in Minnesota (15808) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104755453
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameELIZA S DAHLYCredential: PA-C
Location Address11225 ULYSSES ST NEBlaine, MN 55434-4261
Mailing Address3500 American Blvd W Ste 300Bloomington, MN 55431-4442 · (952) 512-5600
Phone(763) 302-2600
Sole ProprietorNo
Enumeration DateMay 14, 2026
Last NPPES UpdateJune 9, 2026
NPPES CertifiedJune 9, 2026
✔ NPI 1104755453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 15808
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
11225 ULYSSES ST NE, Blaine, MN 55434
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eliza S Dahly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55434 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMUEL JOHN ARNOLD DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
HANNAH MARIE MARTIN DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
SARAH J JENKS DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
ALEXIS HYDUKOVICH DPT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
KACI MARIE TRACZYK PT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
MARY A KOCH PT
Physical Therapist
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
ASHLEY K GANSER PA-C
Physician Assistant
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600
DANIELLE KAY EARP PA-C
Physician Assistant
11225 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (763) 302-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eliza Dahly's NPI number?

The NPI number for Eliza Dahly is 1104755453. It was assigned to this individual provider in the NPPES registry on May 14, 2026.

Where is Eliza Dahly located?

Eliza Dahly practices at 11225 Ulysses St NE, Blaine, MN 55434. The listed phone number is (763) 302-2600.

What is Eliza Dahly's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Eliza Dahly enrolled in Medicare?

Yes. Eliza Dahly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eliza Dahly was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.