Alexa Jordan Habeth, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12962 Issued in MN

Practice address

350 W Burnsville Pkwy Ste 200
Burnsville, MN 55337-2598

Phone

(612) 444-3247

Fax

(612) 888-9247

NPI assigned

Mar 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1508324328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "WILLERNIE",
            "state": "MN",
            "postal_code": "550900272",
            "telephone_number": "612-405-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W BURNSVILLE PKWY STE 200",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372598",
            "telephone_number": "612-444-3247",
            "fax_number": "612-888-9247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 White Bear Ave N Ste 104",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551094568",
            "country_code": "US",
            "telephone_number": "612-444-3247",
            "fax_number": "612-888-9247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABETH",
        "first_name": "ALEXA",
        "middle_name": "JORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy L. Guttormson, M.D.
• Manuel Jose Guzman-Paz, MD
• Anna Haan, OTR
• Tiffany Ann Habben, D.O.
• Alyssa Jordan Haberer, PA-C
• Annabelle Renee Habich
• Richard Neil Hadley, M.D.
• Darcy Ann Hager-Slavin, OTR/L
• Mulki Hagi
• Robert L Hagie, PHARMD

• Physician Assistant in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.