NPIMap

Individual provider Active NPI

Madissen Marie Iten, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1336835800
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14949 Issued in MN
Practice address
9630 Grove Cir N Ste 200
Maple Grove, MN 55369-3492
Phone
(763) 520-7870
NPI assigned
Apr 17, 2023
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 14949 MN Primary

Addresses

Primary practice location

9630 Grove Cir N Ste 200
Maple Grove, MN 55369-3492

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

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
I20240807003598 MN Practitioner - Physician Assistant 5991242927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

16800 37TH PL N
Plymouth, MN 55446-2805
Phone (763) 520-7870

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

9630 Grove Cir N
Suite 200
Maple Grove, MN 55369-3492
Phone (763) 520-7870

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jan 5, 2026 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 5, 2026 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

7866 12th Ave S
Minneapolis, MN 55425

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707

3366 Oakdale Ave N
Ste 103
Robbinsdale, MN 55422

Organizations & group practices 3

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1336835800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9630 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693492",
            "telephone_number": "763-520-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITEN",
        "first_name": "MADISSEN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.