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

ELLERY SAVANNA MAHLUM PA-C
NPI 1326989823
Physician Assistant in Bloomington, MN

Active since April 01, 2026
4300 MARKET PTE DR STE 100, BLOOMINGTON, MN 55435(952) 767-4574 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 2, 2026, Apr 1, 2026 (2 updates tracked since 2026).

About Ellery Savanna Mahlum Pa-c NPPES

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

ELLERY SAVANNA MAHLUM PA-C (NPI 1326989823) is an individual physician assistant in Bloomington, Minnesota, licensed in Minnesota (15964) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1326989823
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameELLERY SAVANNA MAHLUMCredential: PA-C
Location Address4300 MARKET PTE DR STE 100Bloomington, MN 55435-5435
Mailing Address4300 Market Pte Dr Ste 100Bloomington, MN 55435-5435 · (952) 767-4574
Sole ProprietorYes
Enumeration DateApril 1, 2026
Last NPPES UpdateOctober 2, 20262 updates tracked since enumeration
NPPES CertifiedOctober 2, 2026
✔ NPI 1326989823 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 · 15964
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.
4300 MARKET PTE DR STE 100, Bloomington, MN 55435

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.

Physician Assistant
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Physician Assistant
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435
Emergency Medicine
4300 MARKET PTE DR STE 100
BLOOMINGTON, MN 55435

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 Ellery Mahlum's NPI number?

The NPI number for Ellery Mahlum is 1326989823. It was assigned to this individual provider in the NPPES registry on April 1, 2026.

Where is Ellery Mahlum located?

Ellery Mahlum practices at 4300 Market Pte Dr Ste 100, Bloomington, MN 55435. The listed phone number is (952) 767-4574.

What is Ellery Mahlum's specialty?

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

When was this NPI record last updated?

The NPPES record for Ellery Mahlum was last updated on October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.