Austin James Heneman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11882 Issued in MN

Practice address

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306

Phone

(651) 633-6883

Fax

(651) 331-3459

NPI assigned

Aug 5, 2015

Last updated

Dec 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Tareen Dermatology PAGroup PAC ID 8123288156, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.75 of 100Reported as group

Quality

42.73

Promoting interoperability

96

Improvement activities

40

Cost

66.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Tareen Dermatology, P.a.

  • Dermatology Physician
  • Roseville, MN
  • NPI 1063782621

  WI

  Medicare reassignment Care Compare group
• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD (past)
• Tareen Dermatology, PA

  • Non-Pharmacy Dispensing Site
  • Faribault, MN
  • NPI 1215479530
  NPD (past)
• Tareen Dermatology, PA

  • Non-Pharmacy Dispensing Site
  • Maplewood, MN
  • NPI 1851856504
  NPD (past)
• Tareen Dermatology, P.a.

  • Non-Pharmacy Dispensing Site
  • Hudson, WI
  • NPI 1467381293
  NPD (past)

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1093191777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-633-6883",
            "fax_number": "651-331-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-633-6883",
            "fax_number": "651-331-3459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9766 Fallon Ave NE Ste 102",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MN",
            "postal_code": "553624589",
            "country_code": "US",
            "telephone_number": "651-633-6883",
            "fax_number": "651-331-3459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENEMAN",
        "first_name": "AUSTIN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Roseville, MN
• Providers in Roseville, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.