NPIMap

Individual provider Active NPI

Matthew Vang

  • Physician Assistant
  • Vadnais Heights, MN
National Provider Identifier
1144685926
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2380 Issued in MN
Practice address
3588 Arcade St
Vadnais Heights, MN 55127-7135
Phone
(612) 871-1145
NPI assigned
Dec 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 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 2380 MN Primary

Addresses

Primary practice location

3588 Arcade St
Vadnais Heights, MN 55127-7135

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160224001244 MN Practitioner - Physician Assistant 6103121470 Reassigns benefits to 1 organization
I20240621002624 WI Practitioner - Physician Assistant 6103121470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

15700 37TH Ave N
Plymouth, MN 55446-3399
Phone (612) 871-1145

15700 37TH Ave N
Suite 300
Plymouth, MN 55446-3661
Phone (612) 871-1145

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

3588 Arcade St
Suite 110
Vadnais Heights, MN 55127-7135
Phone (612) 871-1145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12008MNMDOrthodontics and Dentofacial Orthopedic Dentist
7639WIMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: matthew.vangpa.p1@direct.mngastro.nextgenshare.com

Organizations & group practices 1

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1144685926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3588 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "612-871-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "2380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

Verify at the official NPI Registry.