NPIMap

Individual provider Active NPI

Tammy Kae Mehlhaus, PA-C

  • Physician Assistant
  • Bloomington, MN
National Provider Identifier
1255669271
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9114 Issued in MN
Practice address
3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5281
Phone
(612) 879-1000
Fax
(612) 879-9116
NPI assigned
Dec 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 9114 MN Primary

Addresses

Primary practice location

3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5281

Mailing address

3601 Minnesota Dr Ste 200
Bloomington, MN 55435-5281
Phone (612) 879-1000

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
I20100304001102 MN Practitioner - Physician Assistant 3476698127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noran Neurological Clinic, P.a.Group PAC ID 3971497389, 54 clinicians

Practice addresses (Care Compare)

2828 Chicago Ave
Suite 200
Minneapolis, MN 55407-4187
Phone (612) 879-1000

2855 Campus Dr
Suite 570
Plymouth, MN 55441-2688
Phone (612) 879-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9114MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Diagnostics LLC Il Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tammymehlhaus@direct.noranclinic.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1255669271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355281",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355281",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHLHAUS",
        "first_name": "TAMMY",
        "middle_name": "KAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.