Michaela Ann Althaus
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Otsego, MN
NPI 1578284709 · NPPES record last updated Sep 6, 2022
Key facts
- NPI
- 1578284709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 12386 69TH LN NE
Otsego, MN 55330-5051 - Phone
- (320) 293-2384
- NPI assigned
- Sep 6, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fairview Express Care
Practice addresses (Care Compare)
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422
717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422
911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-6353
919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344
Hospital & facility affiliations
- Fairview Northland Regional Hospital
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 |
|---|---|---|---|---|
| I20250113000372 | MN | Practitioner - Physician Assistant | 1951839463 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current |
Accepting new patients | |
| Fairview Express Care | Current |
Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients |
Locations
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
Interoperability endpoints
- malthaus676863@fairview.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
12386 69TH LN NE
Otsego, MN 55330-5051
Mailing address
12386 69TH LN NE
Otsego, MN 55330-5051
Phone (320) 293-2384
Other providers in Otsego, MN
- Accurate Home Care, LLC
- Accurate Pca Services, LLC
- Advancements in Vision, PA
- Allsides LLC
- Alpha Home Healthcare LLC
- Amazing Service LLC
- Rita Andik Anang
- Judith M Anderson
- Kelsey Anderson
- Kristin Marie Anderson
All providers in Otsego, MN · Student in an Organized Health Care Education/Training Program in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2022. 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.