Individual provider Active NPI

John S Isenberg, PA-C

  • Physician Assistant
  • Wyoming, MN
National Provider Identifier
1205360526
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12392 Issued in MN
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7300
NPI assigned
Apr 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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 12392 MN Primary

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

15300 Grove Cir N
Maple Grove, MN 55369-4469
Phone (763) 447-2506

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
I20170608001609 MN Practitioner - Physician Assistant 5698043073 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 528-6999

13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone (612) 626-5775

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

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

1700 University Ave W
Saint Paul, MN 55104-3727

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

303 E Nicollet Blvd
Suite 260
Burnsville, MN 55337-4592
Phone (952) 460-4000

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 881-2651

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6525 France Ave S
Suite 100
Edina, MN 55435-2158
Phone (952) 285-6140

6545 France Ave S
Suite 150
Edina, MN 55435-2180
Phone (952) 848-5600

Hospital & facility affiliations

  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12392MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Apr 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

480 Highway 96 E
Vadnais Heights, MN 55127
Phone (651) 326-5900

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: jisenberg348823@fairview.direct-ci.com

Organizations & group practices 17

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 17

Hospital & facility affiliations 6

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1205360526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 GROVE CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694469",
            "telephone_number": "763-447-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISENBERG",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.