Julie A Malnati, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10659 Issued in MN

Practice address

2330 Sioux TRL NW
Prior Lake, MN 55372-9077

Phone

(952) 496-6150

Fax

(952) 233-4224

NPI assigned

May 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Shakopee Mdewakanton Sioux Community

  dba Shakopee Dakota Clinic

  • Family Medicine Physician
  • Prior Lake, MN
  • NPI 1013933381

  Physician Assistant

  Medicare reassignment NPD

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1386802866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SIOUX TRL NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729077",
            "telephone_number": "952-496-6150",
            "fax_number": "952-233-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SIOUX TRL NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729077",
            "telephone_number": "952-496-6150",
            "fax_number": "952-233-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALNATI",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Lubow
• David Henry Lucas, LPN
• Jared Anthony Lutz, DPT
• Shrirang Mahajan, DDS
• Kelsey Rosamond Malmstedt, LPCC, MS, NCC
• Robert Chapman Marshall Jr., PSYD, LP
• Mas24 Transport Inc
• Max Well Therapy LLC (Max Well Physical therapy)
• Ryan McGlenn, RN
• Janelle Clara Meixl, NP

• Physician Assistant in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.