ELIZABETH N BOYUM (PA) – Physician Assistant, NPI 1750320487
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
Provider Addresses for ELIZABETH N BOYUM (PA)
PO BOX 81
CHASKA, MN 553180081
Phone: (888) 398-3327
Type: Mailing
14305 SOUTHCROSS DR W STE 110
BURNSVILLE, MN 553067011
Phone: (651) 340-1064
Type: Mailing
820 SPRINGER DR
LOMBARD, IL 601486413
Phone: (815) 744-8554
Type: Mailing
23505 SMITHTOWN RD STE 120
EXCELSIOR, MN 553314542
Phone: (612) 486-4200
Type: Location
Ridgeview Medical Center, 500, South Maple Street, Waconia, Carver County, Minnesota, 55387, United States
WACONIA, MN 553871752
Phone: (952) 442-2191
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $275.
Total Amount is formed as General ($275) + Research ($0) + Ownership ($0) = $275.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($58).
Total Amount
$275
General + Research + Ownership
Payments
12
Total payment records
General Amount
$275
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2009-06-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090624000191 | I | Physician Assistant | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 472 | 93 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 180 | 156 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 137 | 112 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 101 | 89 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 78 | 75 | $0 |
Insurance plans in this area (ZIP 55318)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | MN | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | PA | |
| D E R M A T O L O G Y | MN | |
| Micrographic Dermatologic Surgery (Mds), Dermatology, Dermatology | MN | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | CO | |
| D E R M A T O L O G Y | MN | |
| Physician Assistant | IL |
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