Individual provider Active NPI

Tiffani I Weingartz, P.A.

  • Physician Assistant
  • St. Paul, MN
National Provider Identifier
1306005574
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10423 Issued in MN
Practice address
640 Jackson Street
Mail Stop 11302C
St. Paul, MN 55101-2502
Phone
(651) 254-2300
Fax
(651) 254-2301
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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 10423 MN Primary

Addresses

Primary practice location

640 Jackson Street
Mail Stop 11302C
St. Paul, MN 55101-2502

Mailing address

PO Box 1309
8170 33Rd Ave S.
Minneapolis, MN 55425-4516
Phone (651) 254-2300

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Other names 1

  • Tiffani I Flategraff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1306005574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "8170 33RD AVE S.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-2300",
            "fax_number": "651-254-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MAIL STOP 11302C",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-2300",
            "fax_number": "651-254-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINGARTZ",
        "first_name": "TIFFANI",
        "middle_name": "I",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANI",
            "last_name": "FLATEGRAFF",
            "middle_name": "I",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St. Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.