NPIMap

Individual provider Active NPI

Patricia Jeanette De Loyal, PA-C

  • Physician Assistant
  • Glencoe, MN
National Provider Identifier
1083081582
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12696 Issued in MN
Practice address
1805 Hennepin Ave N
Glencoe, MN 55336
Phone
(320) 864-3121
Fax
(320) 864-7998
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 12696 MN Primary

Addresses

Primary practice location

1805 Hennepin Ave N
Glencoe, MN 55336

Mailing address

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Other practice location 1

1324 5th St N
New Ulm, MN 56073-1514
Phone (507) 217-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pdeloyal402423@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720001198 MN Practitioner - Physician Assistant 1355611476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical School at San Antonio, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Suite 3
Worthington, MN 56187-1781
Phone (507) 372-6522

1521 Carlson St
Suite 100
Marshall, MN 56258-2626
Phone (507) 473-4800

Hospital & facility affiliations

  • New Ulm Medical Center Hospital, New Ulm, MN, CCN 241378
  • Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 12, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince Aug 20, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince Aug 20, 2022 Accepting new patients
Allina Health System CurrentSince Dec 12, 2022 Accepting new patients
Allina Health System Past Accepting new patients

Locations

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

300 S Bruce St
Ste 100
Marshall, MN 56258

1521 Carlson St
Ste 100
Marshall, MN 56258
Phone (507) 476-4800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

1217 8th St N
New Ulm, MN 56073
Phone (507) 217-5000

1324 5th St N
New Ulm, MN 56073
Phone (507) 217-5000

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 5

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1083081582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "553361416",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 5th St N",
            "address_purpose": "LOCATION",
            "city": "New Ulm",
            "state": "MN",
            "postal_code": "560731514",
            "country_code": "US",
            "telephone_number": "507-217-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LOYAL",
        "first_name": "PATRICIA",
        "middle_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pdeloyal402423@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1324 5th St N",
            "city": "New Ulm",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560731514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glencoe, MN

Sources for this page

Verify at the official NPI Registry.