NPIMap

Individual provider Active NPI

Andrew Timothy Holzwarth, PA-C

  • Physician Assistant
  • Owatonna, MN
National Provider Identifier
1275741175
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12658 Issued in MN
Practice address
2200 NW 26TH St
Owatonna, MN 55060-5503
Phone
(507) 444-5059
NPI assigned
May 21, 2007
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 12658 MN Primary
Athletic Trainer 2255A2300X 0170 SD

Addresses

Primary practice location

2200 NW 26TH St
Owatonna, MN 55060-5503

Mailing address

311 E Roosevelt Cir Apt 107
Mankato, MN 56001-6954
Phone (605) 638-0649

Other practice location 1

1105 W 8th St
Yankton, SD 57078-3725
Phone (605) 668-1397

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aholzwarth263948@ehrdirect.mayoclinicmsg.org

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
I20180328002520 MN Practitioner - Physician Assistant 6709148919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120

2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-3850

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12658MNMDPhysical Therapist
0170SDMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Apr 15, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Apr 15, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

Organizations & group practices 4

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 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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1275741175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E ROOSEVELT CIR APT 107",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016954",
            "telephone_number": "605-638-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-444-5059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Yankton",
            "state": "SD",
            "postal_code": "570783725",
            "country_code": "US",
            "telephone_number": "605-668-1397",
            "fax_number": "605-668-1357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLZWARTH",
        "first_name": "ANDREW",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12658",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aholzwarth263948@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2200 NW 26th St",
            "city": "Owatonna",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550605503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.