Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELLE ELIZABETH PETERSEN PA-C
NPI 1164240446
Physician Assistant in Minneapolis, MN

Q: What is Elle Petersen's NPI number?

The NPI number for Elle Petersen is 1164240446. It was assigned to this individual provider in the NPPES registry on September 26, 2024.

Q: What is Elle Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Elle Petersen was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 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.

Active since September 26, 2024PECOS Enrolled

920 E 28TH ST STE 300, MINNEAPOLIS, MN 55407(612) 863-3900 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 23, 2026, Sep 15, 2026, Aug 26, 2026 and 1 more (4 updates tracked since 2024).

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About Elle Elizabeth Petersen Pa-c NPPES

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

ELLE ELIZABETH PETERSEN PA-C (NPI 1164240446) is an individual physician assistant in Minneapolis, Minnesota, licensed in Minnesota (15915) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164240446

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELLE ELIZABETH PETERSENCredential: PA-C

Location Address920 E 28TH ST STE 300Minneapolis, MN 55407-1195

Mailing Address920 E 28th St Ste 300Minneapolis, MN 55407-1195 · (612) 863-3900

Phone(612) 863-3900

Sole ProprietorNo

Enumeration DateSeptember 26, 2024

Last NPPES UpdateSeptember 23, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2026

✔ NPI 1164240446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 15915

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 15915 (MN)

920 E 28TH ST STE 300, Minneapolis, MN 55407

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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)

Elle Elizabeth Petersen 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 55407 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 6

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

JASON Q. ALEXANDER MD

Surgery (Vascular Surgery)