| Kelly C Greco, PAC | |
|
3800 Park Nicollet Blvd, Department Of Dermatology, St Louis Park, MN 55416-2527 | |
| (952) 993-3260 | |
| (952) 993-0333 |
| Full Name | Kelly C Greco |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 13 Years |
| Location | 3800 Park Nicollet Blvd, St Louis Park, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013356922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 11710 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Allina Health System | 4587573613 | 3844 |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Entity Name | Allina Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295272342 PECOS PAC ID: 4587573613 Enrollment ID: O20040319000460 |
| Entity Name | Allina Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457657249 PECOS PAC ID: 4587573613 Enrollment ID: O20221213001713 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly C Greco, PAC 500 Osborne Rd Ne Dept Of, Fridley, MN 55432-2765 Ph: (763) 786-6011 | Kelly C Greco, PAC 3800 Park Nicollet Blvd, Department Of Dermatology, St Louis Park, MN 55416-2527 Ph: (952) 993-3260 |
Amy Vandenberg, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3850 Park Nicollet Blvd, St Louis Park, MN 55416 Phone: 952-883-1000 |
Kelsey Widmyer Israelson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3850 Park Nicollet Blvd, St Louis Park, MN 55416 Phone: 952-883-1000 |
Ms. Maggie J Koch, O.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 6490 Excelsior Blvd, Ste E400, St Louis Park, MN 55426 Phone: 952-993-3123 |
Lucia F Pierson, OPA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 6465 Wayzata Blvd, Ste 315, St Louis Park, MN 55426 Phone: 952-993-7169 Fax: 952-993-0300 |
Tamara A Johnson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6490 Excelsior Blvd, Ste W200, St Louis Park, MN 55426 Phone: 952-993-3180 |
Mrs. Ann Marie Strong, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: Park Nicollet Clinic-smartcare, 3800 Park Nicollet Blvd Suite 150, St Louis Park, MN 55416 Phone: 952-993-1190 Fax: 952-993-0960 |
Jack William Bergman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3931 Louisiana Ave S, St Louis Park, MN 55426 Phone: 952-993-3230 Fax: 952-993-1748 |