Individual provider Active NPI

Melissa Marie Wachholz, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1386036655
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12345 Issued in MN
Practice address
800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Phone
(612) 863-3900
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 12345 MN Primary

Addresses

Primary practice location

800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723

Mailing address

800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Phone (612) 863-3900

Other practice location 1

701 Park Ave
Orange Building, O5.210
Minneapolis, MN 55415-1623
Phone (612) 873-3000 ext. 3549

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwachholz810603@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: 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
I20170221000571 MN Practitioner - Physician Assistant 1759609209 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-7843

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

7650 Zane Ave N
Brooklyn Park, MN 55443-3151
Phone (612) 873-6963

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12345MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System Inc CurrentSince Feb 9, 2017 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Feb 9, 2017 Accepting new patients
Hennepin Faculty Associates Past Accepting new patients

Locations

715 S 8th St
Minneapolis, MN 55404
Phone (612) 873-6010

7650 Zane Ave N
Minneapolis, MN 55443
Phone (612) 873-0000

701 Park Ave
Bldg O5210
Minneapolis, MN 55415
Phone 6128733000 ext. 3549

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

Interoperability endpoints

  • Direct secure messaging: mwachholz810603@excellian.direct.allina.com

Organizations & group practices 6

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 3

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": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1386036655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_2": "Orange Building, O5.210",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000 x3549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACHHOLZ",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwachholz810603@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St Ste H2100",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.