Individual provider Active NPI

Mattea Marie Cole, PA-C

  • Student in an Organized Health Care Education/Training Program
  • Madison, WI
National Provider Identifier
1417682048
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
750 Highland Ave
Madison, WI 53705-2221
Phone
(218) 340-6324
NPI assigned
Jul 18, 2022
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

750 Highland Ave
Madison, WI 53705-2221

Mailing address

13540 Grove Dr N
Maple Grove, MN 55311-4400

Other names 1

  • Mattea Marie Pavelich 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
I20240918000498 MN Practitioner - Physician Assistant 4284175282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Advocate Urgent Care PLLCGroup PAC ID 4880043082, 18 clinicians
MN UC Providers LTDGroup PAC ID 8729461421, 14 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

11091 Jason Ave NE
Suite 300
Albertville, MN 55301-4699
Phone (763) 260-4750

12643 Fremont Ave
Zimmerman, MN 55398-9755
Phone (218) 838-9355

13540 Grove Dr N
Maple Grove, MN 55311-4400
Phone (952) 931-1276

415 17TH Ave N
Suite 100
Hopkins, MN 55343-7226
Phone (952) 931-1276

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MN UC Providers LTD CurrentSince Nov 21, 2021 Accepting new patients
Allina Health System CurrentSince Feb 3, 2026 Accepting new patients
Allina Health System CurrentSince Feb 3, 2026 Accepting new patients

Locations

415 17th Ave N
Ste 100
Hopkins, MN 55343
Phone (952) 931-1276

13540 Grove Dr N
Maple Grove, MN 55311
Phone (952) 931-1276

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1417682048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13540 GROVE DR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052221",
            "telephone_number": "218-340-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MATTEA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTEA",
            "last_name": "PAVELICH",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.