Individual provider Active NPI

Matthew G Schull, PA-C

  • Physician Assistant
  • Waconia, MN
National Provider Identifier
1588204044
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13154 Issued in MN
Practice address
424 W State Highway 5
Waconia, MN 55387-1795
Phone
(952) 442-4461
Fax
(952) 442-1547
NPI assigned
Jan 13, 2020
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13154 MN Primary

Addresses

Primary practice location

424 W State Highway 5
Waconia, MN 55387-1795

Mailing address

424 W State Highway 5
Waconia, MN 55387-1795
Phone (952) 442-4461

Other practice location 1

313 Territorial St E
Watertown, MN 55388-9284
Phone (952) 955-1921

Other practice location 2

406 Faxon Rd N
Norwood, MN 55368-9507
Phone (952) 467-2888

Other practice location 3

110105 Pioneer Trl W
Chaska, MN 55318-2680
Phone (952) 556-0120

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200225000520 MN Practitioner - Physician Assistant 7719314103 Reassigns benefits to 2 organizations

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
Lakeview Clinic, LTD.Group PAC ID 6002801453, 52 clinicians

Practice addresses (Care Compare)

424 W Hwy 5
Waconia, MN 55387-1723

424 W State Hwy 5
Waconia, MN 55387-1723
Phone (952) 442-4461

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13154MNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Mar 2, 2020 Accepting new patients
The Duluth Clinic, LTD CurrentSince Mar 2, 2020 Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

Interoperability endpoints

  • Direct secure messaging: matthewschull@tv.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1588204044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461",
            "fax_number": "952-442-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461",
            "fax_number": "952-442-1547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 Territorial St E",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "MN",
            "postal_code": "553889284",
            "country_code": "US",
            "telephone_number": "952-955-1921",
            "fax_number": "952-955-3115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "406 Faxon Rd N",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MN",
            "postal_code": "553689507",
            "country_code": "US",
            "telephone_number": "952-467-2888",
            "fax_number": "952-467-3258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110105 Pioneer Trl W",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553182680",
            "country_code": "US",
            "telephone_number": "952-556-0120",
            "fax_number": "952-556-0121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULL",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.