NPIMap

Individual provider Active NPI

Megan Pamela Johnson, PA-C

  • Physician Assistant
  • Edina, MN
National Provider Identifier
1578865952
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11292 Issued in MN
Practice address
6405 France Ave S Ste W400
Edina, MN 55435-2165
Phone
(952) 920-2730
Fax
(952) 567-7090
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1862 MN
Physician Assistant 363A00000X 085.003910 IL
Physician Assistant 363A00000X 11292 MN Primary

Addresses

Primary practice location

6405 France Ave S Ste W400
Edina, MN 55435-2165

Mailing address

6405 France Ave S Ste W400
Edina, MN 55435-2165
Phone (952) 920-2730

Other practice location 1

9550 Upland Ln N Ste 230
Maple Grove, MN 55369-4484
Phone (763) 255-3400

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Other names 1

  • Megan Pamela Knaeble Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130228000460 MN Practitioner - Physician Assistant 2466638598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

6565 France Ave S
Suite 200
Edina, MN 55435-2141
Phone (952) 806-0011

6565 France Ave S
Suite 300
Edina, MN 55435-2154
Phone (952) 223-2100

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1862MNMDPhysical Therapist
085.003910ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2020 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2020 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

9550 Upland Ln N
Ste 230
Maple Grove, MN 55369
Phone 7632553400 ext. 7073

6405 France Ave S
Ste W400
Minneapolis, MN 55435
Phone (952) 920-2730

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

6565 France Ave S
Ste 300
Minneapolis, MN 55435
Phone (952) 223-2100

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

6565 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 806-0011

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578865952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S STE W400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352165",
            "telephone_number": "952-920-2730",
            "fax_number": "952-567-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S STE W400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352165",
            "telephone_number": "952-920-2730",
            "fax_number": "952-567-7090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9550 Upland Ln N Ste 230",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694484",
            "country_code": "US",
            "telephone_number": "763-255-3400",
            "fax_number": "763-255-3490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MEGAN",
        "middle_name": "PAMELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1862",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.003910",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "KNAEBLE",
            "middle_name": "PAMELA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.