NPIMap

Individual provider Active NPI

Martha Macdougal Magnuson, PA-C

  • Physician Assistant
  • Vadnais Heights, MN
National Provider Identifier
1316046931
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10433 Issued in MN
Practice address
3580 Arcade St
Vadnais Heights, MN 55127
Phone
(651) 968-5770
Fax
(651) 968-5775
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 10433 MN Primary

Addresses

Primary practice location

3580 Arcade St
Vadnais Heights, MN 55127

Mailing address

913 E 26TH St Ste 600
Minneapolis, MN 55404-4515

Other practice location 1

3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 968-5770

Other identifiers 3

IdentifierTypeStateIssuer
432035899MedicaidME
1316046931OtherMETRICARE
010453642OtherMEGREATWEST

Other names 1

  • Marth R Macdougal Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmagnuson184242@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
I20090304000295 MN Practitioner - Physician Assistant 5890716039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

225 Smith Ave N
Suite 100
Saint Paul, MN 55102-2533
Phone (651) 292-0007

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

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

8675 Valley Creek Rd
Woodbury, MN 55125-2337
Phone (651) 241-3000

913 E 26TH St
Minneapolis, MN 55404-4515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10433MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Feb 8, 2016 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Jul 3, 2018 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Jul 3, 2018 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Feb 8, 2016 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

1324 5th St N
New Ulm, MN 56073
Phone (507) 217-5000

2855 Campus Dr
Ste 300
Plymouth, MN 55441
Phone (763) 520-2900

2855 Campus Dr
Ste 600
Plymouth, MN 55441
Phone (612) 333-4822

1155 County Road E E
Ste 100
Vadnais Heights, MN 55110
Phone (651) 241-9200

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

Interoperability endpoints

  • Direct secure messaging: martha.magnuson.p2@direct.tcspine.nextgenshare.com
  • Direct secure messaging: mmagnuson184242@excellian.direct.allina.com

Organizations & group practices 9

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1316046931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 E 26TH ST STE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "55127",
            "telephone_number": "651-968-5770",
            "fax_number": "651-968-5775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 Arcade St",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551277135",
            "country_code": "US",
            "telephone_number": "651-968-5770",
            "fax_number": "651-968-5775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "MARTHA",
        "middle_name": "MACDOUGAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432035899",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1316046931",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREATWEST",
            "identifier": "010453642",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmagnuson184242@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "3580 Arcade St",
            "city": "Vadnais Heights",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551277135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTH",
            "last_name": "MACDOUGAL",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vadnais Heights, MN

Sources for this page

Verify at the official NPI Registry.