Mimi Harzan, MSPA, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085008538 Issued in IL

Practice address

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279

Phone

(541) 706-6915

Fax

(541) 706-6733

NPI assigned

May 13, 2020

Last updated

Oct 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mimi Charter Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IL, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Merit-based Incentive Payment System (MIPS)

Final score

82 of 100Reported as group

Quality

55.9

Promoting interoperability

100

Improvement activities

40

Cost

72.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcharter28577@sih.direct-ci.com
• Direct secure messaging: mharzan221190@secure.stcharleshealthcare.org

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.

• St. Charles Health System, Inc.

  dba St. Charles Medical Group

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment Care Compare group NPD
• Southern Illinois Medical Services, NFP

  dba SIH Medical Group

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment Care Compare group NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment
• Vituity - Illinois Auc LLP

  • Emergency Medicine Physician
  • Effingham, IL
  • NPI 1306334198
  Medicare reassignment
• St. Charles Health System, Inc.

  dba The Center at St. Charles Medical Equipment

  • Specialist
  • Bend, OR
  • NPI 1700697935
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • O'Fallon, IL
  • NPI 1467951640
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Vituity - Illinois Auc LLP

  • Emergency Medicine Physician
  • O'Fallon, IL
  • NPI 1487142022
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Healthcare Community Inc

  dba NW High Desert Sleep Center Bend

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba Memorial Hospital of Carbondale

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1477175446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 302",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014279",
            "telephone_number": "541-706-6915",
            "fax_number": "541-706-6733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 S Park Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483602",
            "country_code": "US",
            "telephone_number": "618-942-2002",
            "fax_number": "618-351-6497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Jackson St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARZAN",
        "first_name": "MIMI",
        "credential": "MSPA, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008538",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mharzan221190@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 302",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcharter28577@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcharter28577@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "220 S Park Ave Fl 3",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "CHARTER",
            "credential": "MSPA, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Rae Hartsell, NP
• Kelly Hartsock, M.S. CCC-SLP
• Laurel Hickok Hartwell, M.D.
• Tamara Harty, LPC
• Jodiann Harvey, MA
• Celeste Hasbrouck
• Julie Haskett
• Jordan Hasse, LMT
• Darren G Hassell, LCSW
• Cindy Renea Hatch-Rasmussen, M.A., OTR/L

• Physician Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.