Individual provider Active NPI

Abigail House Tierney, PA

  • Medical Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1437523248
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3100 Kennard St Ste 230
Saint Paul, MN 55109-5465
Phone
(651) 397-0570
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

3100 Kennard St Ste 230
Saint Paul, MN 55109-5465

Mailing address

3100 Kennard St Ste 230
Saint Paul, MN 55109-5465
Phone (651) 397-0570

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
I20160411001949 MN Practitioner - Physician Assistant 7719285584 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2461MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Sep 2, 2017 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2017 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 10, 2016 Accepting new patients
Fairview Health Services CurrentSince Sep 2, 2017 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 10, 2016 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2017 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: aalfaobgyn.abigailtierney@155477.advancedmd-direct.com

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1437523248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 KENNARD ST STE 230",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551095465",
            "telephone_number": "651-397-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 KENNARD ST STE 230",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551095465",
            "telephone_number": "651-397-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "ABIGAIL",
        "middle_name": "HOUSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.