OrganizationActive
Affiliated Otolaryngologists PA
NPI 1912090390 · Otolaryngology Physician · Maple Grove, MN
Provider details
- NPI number
- 1912090390
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Elizabeth Payne, Owner Director(763) 494-9882
- License
- 18878 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12000 Elm Creek Blvd
#l20
Maple Grove, MN 55369-9883
Phone: (763) 494-9882
Fax: (763) 494-9883
Street-level locationGet directions
Mailing address
12000 Elm Creek Blvd
Maple Grove, MN 55369-7163
Registry dates
- Enumerated
- 2006-09-30
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.