Individual provider Active NPI

Maggie Lee McNeill, PA-C

  • Physician Assistant
  • Hermantown, MN
National Provider Identifier
1053931451
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13673 Issued in MN
Practice address
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone
(218) 786-3540
NPI assigned
Apr 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 13673 MN Primary

Addresses

Primary practice location

4855 W Arrowhead Rd
Hermantown, MN 55811-3936

Mailing address

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Other names 1

  • Maggie Lee Essary Ferguson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210331000411 MN Practitioner - Physician Assistant 1951718394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Multi-Specialty Current Accepting new patients
The Duluth Clinic, LTD Multi-Specialty Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Mar 29, 2021 Accepting new patients
The Duluth Clinic, LTD Multi-Specialty CurrentSince Mar 29, 2021 Accepting new patients
The Duluth Clinic, LTD Multi-Specialty Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1587859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1053931451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W ARROWHEAD RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113936",
            "telephone_number": "218-786-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W ARROWHEAD RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113936",
            "telephone_number": "218-786-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEILL",
        "first_name": "MAGGIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-26",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGIE",
            "last_name": "FERGUSON",
            "middle_name": "LEE ESSARY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.