Active NPI
Wade Swoboda, PA-C
- Physician Assistant
- Woodbury, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13393
- Practice address
- 2090 Woodwinds Dr Ste 200
Woodbury, MN 55125-2522 - Phone
- (651) 968-5201
- Fax
- (651) 767-1901
- NPI assigned
- Nov 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13393 | MN | Primary |
Addresses
Primary practice location
2090 Woodwinds Dr Ste 200
Woodbury, MN 55125-2522
Mailing address
710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600
3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300
3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807
4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807
5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13393 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Baldwin Area Medical Center Inc. | Current | Accepting new patients |
Locations
2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076
3545 Highway 61 N
Vadnais Heights, MN 55110
4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076
1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111
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.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
dba Western Wisconsin Health
- Critical Access Hospital
- Baldwin, WI
- NPI 1467496133
-
dba Western Wisconsin Health Spring Valley Clinic
- Clinic/Center
- Spring Valley, WI
- NPI 1164272324
-
- Durable Medical Equipment & Medical Supplies
- Hudson, WI
- NPI 1568840916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1578109765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 COMMERCE DR STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551254925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 WOODWINDS DR STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252522",
"telephone_number": "651-968-5201",
"fax_number": "651-767-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWOBODA",
"first_name": "WADE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-21",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.