Amy Lynn Huseby, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9774 Issued in MN

Practice address

6490 Excelsior Blvd
Ste W200
St Louis Park, MN 55426-4705

Phone

(952) 993-3180

NPI assigned

Dec 16, 2005

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

Other identifiers 1

Other names 1

• Amy Lynn Goebel Former name

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mille Lacs Health System

  dba Critical Access Hospital

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699
  Medicare reassignment NPD
• Welia Health

  • Critical Access Hospital
  • Mora, MN
  • NPI 1528031390
  Medicare reassignment
• Mille Lacs Health System

  dba MLHS Community Pharmacy

  • Community/Retail Pharmacy
  • Onamia, MN
  • NPI 1841947801
  NPD
• Welia Health

  • Rural Health Clinic/Center
  • Pine City, MN
  • NPI 1992012207
  NPD

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1508842105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 210",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 EXCELSIOR BLVD",
            "address_2": "STE W200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264705",
            "telephone_number": "952-993-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSEBY",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876443300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GOEBEL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olivia Jayne Hull
• Laurie Christine Humiston, OTR/L
• Debra Ann Hurley
• Erin Alberto Hurt, SLP
• Lisa Hurtubise, OTR/L
• Abdul-Fatah Hussein
• Shacni Hussin
• Andrea Rae Hutchinson, PSY.D.
• Ellie Johanna Huttner, MSW, LGSW
• Meredith A Hyduke Dehn, MA, LAMFT

• Physician Assistant in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.