Individual provider Active NPI

Cecilia H Sheen, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1225463557
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
424 Harvard St SE
Minneapolis, MN 55455-0362
Phone
(612) 625-5411
Fax
(612) 625-6137
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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 Primary

Addresses

Primary practice location

424 Harvard St SE
Minneapolis, MN 55455-0362

Mailing address

420 Delaware St SE - MMC 480
Minneapolis, MN 55455-0341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131106000098 MN Practitioner - Physician Assistant 1850526559 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1992MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Oct 4, 2013 Accepting new patients
Fairview Health Services CurrentSince Oct 4, 2013 Accepting new patients

Locations

420 Delaware St SE
#480
Minneapolis, MN 55455
Phone (612) 624-0123

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

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

Organizations & group practices 3

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1225463557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE - MMC 480",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550362",
            "telephone_number": "612-625-5411",
            "fax_number": "612-625-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEN",
        "first_name": "CECILIA",
        "middle_name": "H",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.