Individual provider Active NPI

Wendy Roberta Timmons, PAC

  • Physician Assistant
  • Buffalo, MN
National Provider Identifier
1063508414
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10167 Issued in MN
Practice address
303 Catlin St
Buffalo, MN 55313-1947
Phone
(763) 684-6160
Fax
(612) 262-8766
NPI assigned
Oct 5, 2006
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 10167 MN Primary
Dermatology Physician 207N00000X 10167 MN

Addresses

Primary practice location

303 Catlin St
Buffalo, MN 55313-1947

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

4480 Centerville Rd
Saint Paul, MN 55127-3674
Phone (651) 484-2724

Other names 1

  • Wendy Roberta Oosting Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wtimmons697641@excellian.direct.allina.com Direct

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
I20061030000091 MN Practitioner - Physician Assistant 3971551367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

303 Catlin St
Buffalo, MN 55313-1947

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

6350 W 143Rd St
Savage, MN 55378-2890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10167MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Feb 3, 2025 Accepting new patients
Allina Health System CurrentSince Feb 3, 2025 Accepting new patients
NPI 1083910871 Past Accepting new patients
Valeo Health & Wellness Center PLLC PastSince Jan 1, 2009 Accepting new patients
Skin Physicians PA Dermatology Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1063508414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CATLIN ST",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131947",
            "telephone_number": "763-684-6160",
            "fax_number": "612-262-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4480 Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551273674",
            "country_code": "US",
            "telephone_number": "651-484-2724",
            "fax_number": "651-484-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "WENDY",
        "middle_name": "ROBERTA",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10167",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "10167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtimmons697641@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "303 Catlin St",
            "city": "Buffalo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553131947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "OOSTING",
            "middle_name": "ROBERTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.