NPIMap

Individual provider Active NPI

Bishop C Anyiwe, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1487295200
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13186 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Oct 2, 2019
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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 13186 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226000222 MN Practitioner - Physician Assistant 1951735042 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

10961 Club W Pkwy NE
Blaine, MN 55449-4671
Phone (763) 572-5700

14500 99TH Ave N
Maple Grove, MN 55369-4730

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13186MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Oct 20, 2021 Accepting new patients
Fairview Express Care CurrentSince Oct 20, 2021 Accepting new patients
Fairview Express Care CurrentSince Oct 20, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Oct 20, 2021 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Oct 20, 2021 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

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

Interoperability endpoints

  • Direct secure messaging: banyiwe448941@fairview.direct-ci.com

Organizations & group practices 9

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 6

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1487295200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYIWE",
        "first_name": "BISHOP",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.