Thomas Eric Pahl, PA
Individual provider Active NPI Medical Physician Assistant · Onamia, MN
NPI 1487607172 · NPPES record last updated Dec 9, 2015
Key facts
- NPI
- 1487607172
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 9574 (MN)
- Practice address
- 200 Elm St N
Onamia, MN 56359-7901 - Phone
- (320) 532-3154
- Fax
- (320) 532-3111
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Glacial Ridge Hospital District
Practice addresses (Care Compare)
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521
417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157
Hospital & facility affiliations
- Glacial Ridge Hospital
- Prairie Ridge Hospital and Health Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050914001348 | MN | Practitioner - Physician Assistant | 1951334598 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9574 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Past | Accepting new patients | |
| West Central Internal Medicine | Past | Accepting new patients |
Locations
1656 Central St W
Bagley, MN 56621
Phone (218) 694-2384
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157
417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/glac-1755385c
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 9574 | MN | Yes |
Addresses
Primary practice location
200 Elm St N
Onamia, MN 56359-7901
Mailing address
10 Fourth Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA9091026947 | Other | MN | PREFERRED ONE |
| 258696700 | Medicaid | MN |
Other providers in Onamia, MN
- Rosalie Noonday
- Onamia Area Assisted Living
- Onamia Pharmacy LLC
- Dawn Marie Osterman
- Lee Ann Otkin
- Vicki L Parsons
- Corey Pieper
- Kirsten Tina Marie Posch
- Alicia Remer
- Laurieann Bernice Richards
All providers in Onamia, MN · Medical Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.