NPIMap

Individual provider Active NPI

Wilfred Oakley Stout, PAC

  • Physician Assistant
  • Oak Park Heights, MN
National Provider Identifier
1548669955
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3442 Issued in WI
Practice address
5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Aug 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 11732 MN
Physician Assistant 363A00000X 3442 WI Primary
Surgical Physician Assistant 363AS0400X 3442-23 WI
Physician Assistant 363A00000X 11732 MN

Addresses

Primary practice location

5803 Neal Ave N
Oak Park Heights, MN 55082-2177

Mailing address

5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone (651) 439-8807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141021002190 MN Practitioner - Physician Assistant 0547481293 Reassigns benefits to 1 organization
I20150211001829 WI Practitioner - Physician Assistant 0547481293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westfields Hospital IncGroup PAC ID 2264490960, 108 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3442WIMDPhysician Assistant
11732MNMDSurgical Physician Assistant
3442-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tria Orthopaedic Center LLC CurrentSince Nov 18, 2019 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jan 5, 2023 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Lakeview Memorial Hospital Association Inc. Past Accepting new patients
Hudson Hospital, Inc Past Accepting new patients

Locations

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

411 Stageline Rd
#100
Hudson, WI 54016

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

Organizations & group practices 5

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1548669955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "WILFRED",
        "middle_name": "OAKLEY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "11732",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3442",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "3442-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park Heights, MN

Sources for this page

Verify at the official NPI Registry.