Mark Wayne Bingham, PA-C

Key facts

NPI

1316980907

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

10115 (MN)

Practice address

1202 5TH Grant Blvd
Wabasha, MN 55981-1042

Phone

(651) 565-4571

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316980907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 5TH GRANT BLVD",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 5TH GRANT BLVD",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "MARK",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabasha, MN

• Soleil Arrieta, M.D.
• Kathleen Barrett, O.T.R.
• Anna Emily Battcher, PHARMD
• Allison Hart Beito, MD
• Laurie Lynn Bell, CNA
• Grace Bouquet Boyle, DC
• Amanda Lynne Brees, EDD RMT C-IAYT
• Remington James Brisbois, DDS
• Susan J. Buck, FNP
• Brianna Byam

All providers in Wabasha, MN · Physician Assistant in Minnesota