Individual provider Active NPI

Joseph M Uzpen, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1043200389
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-5099
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-5099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130515000274 MN Practitioner - Physician Assistant 7416194287 Reassigns benefits to 2 organizations
I20240531001032 WI Practitioner - Physician Assistant 7416194287 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7308WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Hospital, Inc. CurrentSince Apr 17, 2024 Accepting new patients
Regions Hospital CurrentSince May 15, 2013 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Jul 5, 2023 Accepting new patients
Lakeview Memorial Hospital Association Inc. CurrentSince Jul 5, 2023 Accepting new patients
Hudson Hospital, Inc Past Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

640 Jackson St
#11102F
Saint Paul, MN 55101
Phone (651) 254-3456

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1043200389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZPEN",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.