Individual provider Active NPI

Margaret Kennealy

  • Physician Assistant
  • Waconia, MN
National Provider Identifier
1376999482
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
424 W Highway 5
Waconia, MN 55387-1723
Phone
(952) 442-4461
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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 Primary

Addresses

Primary practice location

424 W Highway 5
Waconia, MN 55387-1723

Mailing address

424 W Highway 5
Waconia, MN 55387-1723

Other names 1

  • Margaret Ault Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921000695 MN Practitioner - Physician Assistant 1759678683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Clinic, LTD.Group PAC ID 6002801453, 52 clinicians

Practice addresses (Care Compare)

424 W Hwy 5
Waconia, MN 55387-1723

424 W State Hwy 5
Waconia, MN 55387-1723
Phone (952) 442-4461

Hospital & facility affiliations

  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: margaretkennealy@tv.allscriptsdirect.net

Organizations & group practices 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1376999482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871723",
            "telephone_number": "952-442-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEALY",
        "first_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "AULT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.