Individual provider Active NPI

Mai See Thao, PA-C

  • Medical Physician Assistant
  • Andover, MN
National Provider Identifier
1245420710
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone
(763) 392-4001
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MN Primary

Addresses

Primary practice location

13819 Hanson Blvd NW
Andover, MN 55304-7608

Mailing address

8508 Emery Pkwy N
Champlin, MN 55316-2494
Phone (763) 442-7872

Other identifiers 1

IdentifierTypeStateIssuer
107717OtherMNNCCPA ID

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
I20090402000503 MN Practitioner - Physician Assistant 3870640113 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 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

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Feb 25, 2020 Accepting new patients
Fairview Health Services CurrentSince Apr 8, 2017 Accepting new patients
Fairview Clinics CurrentSince Apr 8, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 25, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 24, 2021 Accepting new patients
Fairview Health Services CurrentSince Apr 8, 2017 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Mar 24, 2021 Accepting new patients
Fairview Clinics CurrentSince Apr 8, 2017 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

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

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

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

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

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

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

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

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

Interoperability endpoints

  • Direct secure messaging: mthao402309@fairview.direct-ci.com

Organizations & group practices 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1245420710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8508 EMERY PKWY N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162494",
            "telephone_number": "763-442-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13819 HANSON BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553047608",
            "telephone_number": "763-392-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "MAI",
        "middle_name": "SEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA ID",
            "identifier": "107717",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.