Individual provider Active NPI

James Theodore Riggen, P.A.

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1083946032
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10945 Issued in MN
Practice address
407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950
Phone
(218) 786-4357
NPI assigned
Feb 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9105381 FL
Physician Assistant 363A00000X 10945 MN Primary

Addresses

Primary practice location

407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950

Mailing address

407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950
Phone (218) 786-4357

Other identifiers 1

IdentifierTypeStateIssuer
PA9105381OtherFLMEDICAL LICENSE

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
I20110629000539 MN Practitioner - Physician Assistant 5496933038 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105381FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Memorial Hospital Association Inc CurrentSince Dec 1, 2016 Accepting new patients
Mille Lacs Health System CurrentSince Apr 13, 2015 Accepting new patients
Lakeview Memorial Hospital Association Inc. CurrentSince Dec 1, 2016 Accepting new patients
Regions Hospital CurrentSince Dec 1, 2016 Accepting new patients
Mille Lacs Health System CurrentSince Apr 13, 2015 Accepting new patients
Park Nicollet Clinic CurrentSince May 22, 2015 Accepting new patients
Park Nicollet Clinic CurrentSince May 22, 2015 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1083946032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "address_2": "ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "address_2": "ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGGEN",
        "first_name": "JAMES",
        "middle_name": "THEODORE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105381",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9105381",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.