Wesley Nathan Wormington, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14197 Issued in MN

Practice address

777 Raymond Ave
Saint Paul, MN 55114-1522

Phone

(651) 447-3755

Fax

(651) 444-8923

NPI assigned

Mar 4, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Sasaki Medical LLC

  • Addiction Medicine (Family Medicine) Physician
  • Roseville, MN
  • NPI 1326490475
  Medicare reassignment NPD

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1083006753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141522",
            "telephone_number": "651-447-3755",
            "fax_number": "651-444-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141522",
            "telephone_number": "651-447-3755",
            "fax_number": "651-444-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMINGTON",
        "first_name": "WESLEY",
        "middle_name": "NATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-04",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2015006472",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley A Woolner, M.D.
• Sandra J. Woolsey, M.A. LPCC
• Alexander Wooner, MD
• Getenet Worku
• Kalkidan D Worku
• Bernard J Worth, MD
• Workinesh Abdella Woticha
• Richard Wrigfht, L.A.D.C.
• Wright Care Services Inc
• Jacquelyn Wright Wagner, PSY.D.

• Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, 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 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.