NPIMap

Individual provider Active NPI

Maia Ellen Macneal, PA-C, MPAS

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1467926931
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(303) 436-6000
NPI assigned
Jan 17, 2019
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

777 Bannock St
Denver, CO 80204-4507

Mailing address

777 Bannock St
Denver, CO 80204-4597

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2595
Phone (651) 254-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, CO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190502003004 MN Practitioner - Physician Assistant 6305188814 Reassigns benefits to 2 organizations
I20210824003280 WI Practitioner - Physician Assistant 6305188814 Reassigns benefits to 4 organizations
I20230713002323 CO Practitioner - Physician Assistant 6305188814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12950MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Mar 24, 2019 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jun 29, 2021 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Mar 24, 2019 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jun 29, 2021 Accepting new patients
Westfields Hospital, Inc CurrentSince Jun 6, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 1, 2023 Accepting new patients
Lakeview Memorial Hospital Association Inc. CurrentSince Mar 24, 2019 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jun 6, 2024 Accepting new patients
Regions Hospital Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

Organizations & group practices 10

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.

Hospital & facility affiliations 10

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1467926931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012595",
            "country_code": "US",
            "telephone_number": "651-254-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACNEAL",
        "first_name": "MAIA",
        "middle_name": "ELLEN",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2023-07-12",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.