Jaime Evan Glader, PA-C
Individual provider Active NPI Physician Assistant · Wyoming, MN
NPI 1275834640 · NPPES record last updated May 10, 2021
Key facts
- NPI
- 1275834640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10834 (MN)
- Practice address
- 5130 Fairview Blvd Ste 100
Wyoming, MN 55092-8050 - Phone
- (651) 439-8807
- Fax
- (651) 439-0232
- NPI assigned
- Nov 16, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1700 University Ave W
Saint Paul, MN 55104-3727
3033 Gettysburg Ave N
Minneapolis, MN 55427-2306
3500 American Blvd W
Suite 300
Bloomington, MN 55431-4442
720 Washington Ave SE
Suite 200
Minneapolis, MN 55414-2924
Hospital & facility affiliations
- Fairview Lakes Health Services
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110321000964 | MN | Practitioner - Physician Assistant | 5698958197 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10834 | MN | MD | Physician Assistant |
| 2679-023 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healtheast Medical Research Insititue | Current |
Accepting new patients | |
| Healtheast Medical Research Institute | Current |
Accepting new patients | |
| Infinite Health Collaborative, PA | Past | Accepting new patients |
Locations
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2679-023 | WI | |
| Physician Assistant | 363A00000X | 10834 | MN | Yes |
Addresses
Primary practice location
5130 Fairview Blvd Ste 100
Wyoming, MN 55092-8050
Mailing address
5130 Fairview Blvd Ste 100
Wyoming, MN 55092-8050
Phone (651) 439-8807
Other providers in Wyoming, MN
- David Anthony Galleberg
- Matthew James Garrison
- Kelsey Elizabeth Gelhaus
- Michael A Germain
- John R Gilbert
- Melissa Lynn Gleaves
- Elizabeth Glenna
- Erica Gloppen
- Brianna Marie Glynn
- Trevor Ryan Goldsmith
All providers in Wyoming, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.