Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elizabeth N Boyum, PA

Individual provider Physician Assistant · NPI 1750320487

Elizabeth N Boyum, PA is a Physician Assistant in Burnsville, Minnesota. Qualified in 2002, 24 years ago. Practices with Lakes Dermatology PA, a 9-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
24
Licensed in
MN
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

14305 Southcross Dr W Ste 110
Burnsville, MN 55306-7011
Phone: (513) 401-0646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9778 (MN)

Record details

NPI number1750320487
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 6, 2006
Last updated in NPPESApril 22, 2025
Certification dateApril 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Lakes Dermatology Pa — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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