NPIMap

Individual provider Active NPI

Mathias P Connally, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1245680214
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13868 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-2005
Fax
(651) 254-1519
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA196165 OR
Surgical Physician Assistant 363AS0400X PA196165 OR
Physician Assistant 363A00000X 13868 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

8100 W 78th St Ste 230
Edina, MN 55439-2570
Phone (952) 946-9777

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mconnally699301@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215001235 MN Practitioner - Physician Assistant 0042503161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

927 Churchill W St
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13868MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 10, 2025 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2022 Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2022 Accepting new patients
Allina Health System CurrentSince Mar 10, 2025 Accepting new patients
Allina Health System Past Accepting new patients
Group Health, Inc. Past Accepting new patients
Regions Hospital Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8100 W 78th St
Ste 230
Minneapolis, MN 55439
Phone (888) 892-7575

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

Interoperability endpoints

  • Direct secure messaging: mconnally699301@excellian.direct.allina.com
  • Direct secure messaging: mpconnal@yourcarecommunity.org

Organizations & group practices 8

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1245680214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-2005",
            "fax_number": "651-254-1519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 W 78th St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554392570",
            "country_code": "US",
            "telephone_number": "952-946-9777",
            "fax_number": "952-946-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNALLY",
        "first_name": "MATHIAS",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA196165",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA196165",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mconnally699301@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8100 W 78th St Ste 230",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554392570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.