CMS-1500 Box 24J / 33a • NPI
1487900577
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207N00000X (CMS 07)
Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)
Box 32 Service Location & ZIP+4
1900 CENTRACARE CIR, SUITE 2575, ST CLOUD, MN, 56303-5000
✓ 9-Digit EDI 837 ZIP+4 (56303-5000)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1487900577 (ELIZABETH KATE BLIXT, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1487900577)
Medicare Beneficiaries
554
Total Billed Services
3,136
Distinct CPT/HCPCS Codes
80
Medicare Allowed Total
$244,235.71
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
11102 | Biopsy of related skin growth, first growth | 111 |
11103 | Biopsy of related skin growth, each additional growth | 77 |
11104 | Punch biopsy, first skin growth | 14 |
11300 | Shaving of skin growth of body, arms, or legs, 0.5 cm or less | 14 |
11900 | Injection into skin growth, 1-7 growths | 30 |
12032 | Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm | 33 |
12052 | Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm | 31 |
17000 | Destruction of precancer skin growth, 1 growth | 208 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Adbry Tralokinumab-Ldrm | 11 | <11 |
| Betamethasone Diprop Augmented Betamethasone/Propylene Glyc | 25 | 18 |
| Calcipotriene Calcipotriene | 16 | <11 |
| Cefadroxil Cefadroxil | 22 | 22 |
| Clindamycin Phosphate Clindamycin Phosphate | 22 | <11 |
| Clobetasol Propionate Clobetasol Propionate | 173 | 90 |
| Cosentyx Unoready Pen Secukinumab | 15 | <11 |
| Dapsone Dapsone | 17 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1487900577 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ELIZABETH KATE BLIXT, MD |
| Plain-English Specialty | Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: 207N00000X (Dermatology) |
| Certifying / Licensing Body | American Board of Dermatology (ABD) |
| Practice Location Address | 1900 CENTRACARE CIR, SUITE 2575, ST CLOUD, MN, 56303-5000 |
| Practice Telephone / Fax | Tel: (320) 229-4924 | Fax: (320) 229-4971 |
| Administrative Mailing Address | 1900 CENTRACARE CIR, ST CLOUD, MN, 56303-5000 |
| Enumeration & Last Sync | Enumerated: 2012-07-26 | CMS Record Updated: 2016-06-14 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207N00000X)
What Does Taxonomy Code 207N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207N00000X translates to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ELIZABETH KATE BLIXT, MD)
Typical CPT / Diagnostic Procedures:- Full-Body Dermoscopy & Skin Cancer Screening
- Shave, Punch & Excisional Skin Biopsy (CPT 11102–11107)
- Cryotherapy Destruction of Actinic Keratoses & Viral Warts (CPT 17000)
- Topical Corticosteroids (Triamcinolone, Clobetasol) & Calcineurin Inhibitors
- Topical & Oral Retinoids (Tretinoin, Adapalene, Isotretinoin)
- Doxycycline, Minocycline & Antifungals (Terbinafine, Ketoconazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: MN | License: 56812 | Primary: Yes (Primary) |
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: MN | License: 107024 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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