Maisy Monica Sanneman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10302 Issued in MN

Practice address

6525 France Ave. S.
Suite 200
Edina, MN 55435

Phone

(952) 927-6501

Fax

(952) 922-1623

NPI assigned

Oct 5, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Urology, PAGroup PAC ID 0840183984, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Merit-based Incentive Payment System (MIPS)

Final score

84.84 of 100Reported as group

Quality

64.59

Promoting interoperability

100

Improvement activities

40

Cost

84.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maisy.sanneman.1@20581.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minnesota Urology, PA

  • Urology Physician
  • Woodbury, MN
  • NPI 1912971912
  Medicare reassignment Care Compare group
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment
• Allina Health System

  • Internal Medicine Physician
  • Hastings, MN
  • NPI 1881118149
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1013105907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 FRANCE AVE. S.",
            "address_2": "SUITE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-927-6501",
            "fax_number": "952-922-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 FRANCE AVE. S.",
            "address_2": "SUITE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-927-6501",
            "fax_number": "952-922-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNEMAN",
        "first_name": "MAISY",
        "middle_name": "MONICA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanderson Eye PLLC
• Jeffrey Paul Sanderson, M.D.
• Scott Ehren Sanderson, M.D.
• Rachel Lynn Sang, MD
• Farhad William Sani, M.D.
• Prachi Sansare
• Guido E Santacana-Laffitte, MD
• David Alan Santella, LMFT
• Gabriela A. Santos Nunez, MD
• Jeffrey Sarberg

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.