Individual provider Active NPI

Michael E Shipman, PA-C

  • Physician Assistant
  • Bloomer, WI
National Provider Identifier
1407847767
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2219 Issued in WI
Practice address
1501 Thompson St
Bloomer, WI 54724-1257
Phone
(715) 838-5222
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 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 2219-23 WI
Physician Assistant 363A00000X 2219 WI Primary

Addresses

Primary practice location

1501 Thompson St
Bloomer, WI 54724-1257

Mailing address

200 1St St SW
Rochester, MN 55905
Phone (715) 838-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080913000171 WI Practitioner - Physician Assistant 2466528500 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2219WIMDPhysician Assistant
2219-23WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Dec 14, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

1010 High St
Colfax, WI 54730
Phone (715) 926-3117

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Interoperability endpoints

  • Direct secure messaging: mshipman24921@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1407847767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 THOMPSON ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241257",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2219-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomer, WI

Sources for this page

Verify at the official NPI Registry.