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PEDIATRIC AND YOUNG ADULT MEDICINE, PA
NPI 1457593550
Clinic/Center - Primary Care in Lake Elmo, MN

Active since April 03, 2009
8650 HUDSON BLVD N, SUITE 125, LAKE ELMO, MN 55042(651) 256-6706(651) 256-6707 Get Directions Write a Review

NPPES record last updated: December 7, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric And Young Adult Medicine, Pa NPPES

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

PEDIATRIC AND YOUNG ADULT MEDICINE, PA (NPI 1457593550) is a healthcare organization registered as a primary care in Lake Elmo, Minnesota and active in the NPI registry since April 2009. The organization lists Terri M Joseph, Clinic Administrator, as its authorized official.

NPPES Registry Identity

NPI1457593550
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePEDIATRIC AND YOUNG ADULT MEDICINE, PA
Location Address8650 HUDSON BLVD N, SUITE 125Lake Elmo, MN 55042-9747
Mailing Address1804 7th St W, Suite 200Saint Paul, MN 55116-2300 · (651) 256-6706 · Fax (651) 256-6707
Phone(651) 256-6706
Fax(651) 256-6707
Organization SubpartNo
Authorized OfficialTerri M JosephClinic Administrator · (651) 256-6706
Enumeration DateApril 3, 2009
Last NPPES UpdateDecember 7, 2016
✔ NPI 1457593550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MN · 154
8650 HUDSON BLVD N, Lake Elmo, MN 55042
Open in Google Maps ↗

Other Identifiers 10

Medicaid1083694046MN
Medicaid1245210095MN
Medicaid1245210210MN
Medicaid1497735419MN
Medicaid1881057065MN
Medicaid1104806165MN
Medicaid1861558835MN
Medicaid1386991339MN
Medicaid1912987900MN
Medicaid1477870921MN

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.

MICHELLE CUNNINGHAM
Nurse Anesthetist, Certified Registered
8650 HUDSON BLVD N, SUITE 235
LAKE ELMO, MN 55042
Washington County (651) 702-7400
JOHN R LOWE CRNA
Nurse Anesthetist, Certified Registered
8650 HUDSON BLVD N
LAKE ELMO, MN 55042
Washington County (651) 702-7400
JAMES R BENYON CRNA
Nurse Anesthetist, Certified Registered
8650 HUDSON BLVD N
LAKE ELMO, MN 55042
Washington County (651) 702-7400
WILLIAM C MOORE CRNA
Nurse Anesthetist, Certified Registered
8650 HUDSON BLVD N
LAKE ELMO, MN 55042
Washington County (651) 702-7400
MOLLY L SORENSON PT
Physical Therapist
8650 HUDSON BLVD N, SUITE 310
LAKE ELMO, MN 55042
Washington County (651) 702-6932
MARK L THURNBECK OTR
Occupational Therapist
8650 HUDSON BLVD N, SUITE 310
LAKE ELMO, MN 55042
Washington County (651) 702-6932
LAKEVIEW HOSPITAL INC.
Pharmacy (Clinic Pharmacy)
8650 HUDSON BLVD N, SUITE 100
LAKE ELMO, MN 55042
Washington County (651) 702-7212
MARK J MAYRY CRNA
Nurse Anesthetist, Certified Registered
8650 HUDSON BLVD N
LAKE ELMO, MN 55042
Washington County (651) 702-7400

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 Pediatric And Young Adult Medicine, PA's NPI number?

The NPI number for Pediatric And Young Adult Medicine, PA is 1457593550. It was assigned to this organization in the NPPES registry on April 3, 2009.

Where is Pediatric And Young Adult Medicine, PA located?

Pediatric And Young Adult Medicine, PA is located at 8650 Hudson Blvd N Suite 125, Lake Elmo, MN 55042. The listed phone number is (651) 256-6706.

What is Pediatric And Young Adult Medicine, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Pediatric And Young Adult Medicine, PA was last updated on December 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.