Active NPI
Mai Z Vang
- Physician Assistant
- Saint Paul, MN
National Provider Identifier
1063197697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1544 Timberlake Rd
Saint Paul, MN 55117-3946 - Phone
- (651) 602-7500
- NPI assigned
- Jun 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | MN | Primary |
Addresses
Primary practice location
1544 Timberlake Rd
Saint Paul, MN 55117-3946
Mailing address
20760 Xavis St NW
Oak Grove, MN 55011-9277
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250820000193 | MN | Practitioner - Physician Assistant | 9133628704 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Wisconsin School of Medicine, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Side Community Health Services, Inc.
Practice addresses (Care Compare)
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 602-7500
1544 Timberlake Rd
Saint Paul, MN 55117-3946
Phone (651) 602-7500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Side Community Health Services, Inc. | Current | Accepting new patients | |
| West Side Community Health Services, Inc. | Current | Accepting new patients |
Locations
1544 Timberlake Rd
Saint Paul, MN 55117
Phone (651) 558-2191
153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816
Interoperability endpoints
- mvang832913@direct.ochin.org
Organizations & group practices 17
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.
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1821149964
MN
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- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
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- Federally Qualified Health Center (FQHC)
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-
- Federally Qualified Health Center (FQHC)
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- NPI 1295886208
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1437118619
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1023201811
-
- Federally Qualified Health Center (FQHC)
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- NPI 1083765135
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- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1205397395
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1407049653
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1427106871
-
- Federally Qualified Health Center (FQHC)
- St Paul, MN
- NPI 1457475543
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1649394727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756080000000",
"number": "1063197697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20760 XAVIS ST NW",
"city": "OAK GROVE",
"state": "MN",
"postal_code": "550119277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1544 TIMBERLAKE RD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551173946",
"telephone_number": "651-602-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "MAI",
"middle_name": "Z",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-20",
"last_updated": "2025-08-25",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.