Individual provider Active NPI

Shana Marie Pazdernik-Hensch, PA

  • Physician Assistant
  • Wadena, MN
National Provider Identifier
1386382240
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone
(218) 631-3510
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

4 Deerwood Ave NW
Wadena, MN 56482-1253

Mailing address

26084 County Highway 67
Henning, MN 56551-9301
Phone (218) 280-2221

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
I20220915000653 MN Practitioner - Physician Assistant 9234514068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Astera HealthGroup PAC ID 2961395272, 106 clinicians

Practice addresses (Care Compare)

102 S Farwell St
Verndale, MN 56481-4250
Phone (218) 445-5990

214 1St St NW
PO Box 67
Bertha, MN 56437-1295
Phone 21863281238123

4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360

401 Douglas Ave
Henning, MN 56551-4026
Phone (218) 583-2953

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

415 Jefferson St N
Wadena, MN 56482-1296

Hospital & facility affiliations

  • Astera Health Hospital, Wadena, MN, CCN 241354

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14099MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health CurrentSince Sep 1, 2022 Accepting new patients
Astera Health CurrentSince Sep 1, 2022 Accepting new patients

Locations

4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Interoperability endpoints

  • Direct secure messaging: spazdernikhensch634481@direct.centracare.com

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 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": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1386382240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26084 COUNTY HIGHWAY 67",
            "city": "HENNING",
            "state": "MN",
            "postal_code": "565519301",
            "telephone_number": "218-280-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DEERWOOD AVE NW",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821253",
            "telephone_number": "218-631-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZDERNIK-HENSCH",
        "first_name": "SHANA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadena, MN

Sources for this page

Verify at the official NPI Registry.