ELISABETH JEAN MCCLEAN (MD) – Family Medicine Physician, NPI 1003173469

ELISABETH JEAN MCCLEAN (MD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 56640 (MN). The NPI Number for ELISABETH JEAN MCCLEAN (MD) is 1003173469

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
ELISABETH JEAN MCCLEAN (MD)
NPI
1003173469
Phone
(612) 302-8200
Address
1020 W Broadway Ave
Enumeration Date
23 April 2012
Last Update Date
11 December 2019

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
9529933123
Graduation Year
2012 (14 years ago)
PAC ID
7113168766
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20130725000048
Address ID
MN554162527ST3850XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

Provider Addresses for ELISABETH JEAN MCCLEAN (MD)

  • 1020 W Broadway Ave

    Minneapolis, MN 55411

    Phone: (612) 302-8200

    Fax: (612) 302-8275

    Type: Location

  • 3850 PARK NICOLLET BLVD

    ST LOUIS PARK, MN 554162527

    Phone: (952) 883-1000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-07-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130725000048IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes214208$0
36415Insertion of needle into vein for collection of blood sample6460$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count5047$0
99214Established patient office or other outpatient visit, 30-39 minutes3837$0
81001Manual urinalysis test with examination using microscope, automated2727$0
View full utilization report →

Insurance plans in this area (ZIP 55411)

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Provider's Procedures

ELISABETH JEAN MCCLEAN (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMN83036Hemoglobin A1C level1913
FAMILY MEDICINEMN85610Blood test, clotting time4212

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN
-MN

Reviews

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Frequently asked questions

Can I use this page to confirm ELISABETH JEAN MCCLEAN (MD)'s NPI?
Yes. ELISABETH JEAN MCCLEAN (MD) is listed with NPI 1003173469 in the public NPI dataset.
Does the file indicate ELISABETH JEAN MCCLEAN (MD) is practicing under active NPI?
Directory data currently reports ELISABETH JEAN MCCLEAN (MD) as active.
What is ELISABETH JEAN MCCLEAN (MD)'s primary classification?
Family Medicine Physician is the headline specialty for ELISABETH JEAN MCCLEAN (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for ELISABETH JEAN MCCLEAN (MD)?
ELISABETH JEAN MCCLEAN (MD)'s geographic hint is Minneapolis, Minnesota in our summary view.
Why does ELISABETH JEAN MCCLEAN (MD) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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