Individual provider Active NPI

Levon John Mueller, PA-C

  • Physician Assistant
  • Waconia, MN
National Provider Identifier
1093555682
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14907 Issued in MN
Practice address
560 S Maple St Ste 200
Waconia, MN 55387-1757
Phone
(952) 442-2163
Fax
(952) 442-5903
NPI assigned
May 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 14907 MN Primary

Addresses

Primary practice location

560 S Maple St Ste 200
Waconia, MN 55387-1757

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

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
I20240719002707 MN Practitioner - Physician Assistant 8527504000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

111 Hundertmark Rd
Suite 240
Chaska, MN 55318-1198
Phone (952) 456-7400

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

820 Village Way
Waconia, MN 55387-4612

Hospital & facility affiliations

  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14907MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Aug 5, 2024 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Aug 5, 2024 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

111 Hundertmark Rd
Ste 240
Chaska, MN 55318
Phone (952) 456-7400

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

560 S Maple St
Ste 200
Waconia, MN 55387
Phone (952) 856-4033

820 Village Way
Ste 100
Waconia, MN 55387
Phone (952) 927-2960

820 Village Way
#200
Waconia, MN 55387

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1093555682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST STE 200",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871757",
            "telephone_number": "952-442-2163",
            "fax_number": "952-442-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "LEVON",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.