Individual provider Active NPI

Gina Orourke Peschel, PAC

  • Physician Assistant
  • Excelsior, MN
National Provider Identifier
1588866255
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9668 Issued in MN
Practice address
675 Water St
Excelsior, MN 55331-3063
Phone
(952) 906-7855
Fax
(952) 470-4523
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9668 MN Primary

Addresses

Primary practice location

675 Water St
Excelsior, MN 55331-3063

Mailing address

675 Water St
Excelsior, MN 55331-3063
Phone (952) 906-7855

Other identifiers 1

IdentifierTypeStateIssuer
16686300MedicaidMN

Other names 1

  • Gina Marie Orourke Former name

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
I20041007000669 MN Practitioner - Physician Assistant 7416916036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

111 Hundertmark Rd
Suite 115N
Chaska, MN 55318-1584
Phone (952) 442-7820

560 S Maple St
Waconia, MN 55387-1757

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center CurrentSince Mar 2, 2010 Accepting new patients
Ridgeview Medical Center CurrentSince Mar 2, 2010 Accepting new patients
Ridgeview Clinics Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Carlson Chiropractic Health and Healing Inc. PastSince Jun 7, 2018 Accepting new patients

Locations

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 115N
Chaska, MN 55318
Phone (952) 361-2450

675 Water St
Excelsior, MN 55331
Phone (952) 906-7855

4695 Shoreline Dr
Spring Park, MN 55384
Phone (952) 442-7890

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

560 S Maple St
Ste 220
Waconia, MN 55387
Phone (952) 442-8011

560 S Maple St
Ste 400
Waconia, MN 55387
Phone (952) 442-3188

560 S Maple St
Ste 40
Waconia, MN 55387
Phone (952) 925-5626

Organizations & group practices 6

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 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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588866255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 WATER ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313063",
            "telephone_number": "952-906-7855",
            "fax_number": "952-470-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 WATER ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313063",
            "telephone_number": "952-906-7855",
            "fax_number": "952-470-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCHEL",
        "first_name": "GINA",
        "middle_name": "OROURKE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16686300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "OROURKE",
            "middle_name": "MARIE",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Excelsior, MN

Sources for this page

Verify at the official NPI Registry.