Individual provider Active NPI

Amanda Mattson, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1619524659
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13441 Issued in MN
Practice address
420 Delaware St SE
Minneapolis, MN 55455-0341
Phone
(612) 625-4652
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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 13441 MN Primary

Addresses

Primary practice location

420 Delaware St SE
Minneapolis, MN 55455-0341

Mailing address

420 Delaware St SE
MMC D-410
Minneapolis, MN 55455-0341
Phone (612) 625-4652

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
I20210218002800 MN Practitioner - Physician Assistant 8628483922 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (763) 525-1746

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13441MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 27, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 27, 2022 Accepting new patients
Fairview Express Care CurrentSince Jun 27, 2022 Accepting new patients
Fairview Health Services CurrentSince May 27, 2022 Accepting new patients
Fairview Clinics CurrentSince May 27, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 11, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 27, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 11, 2020 Accepting new patients
Fairview Health Services CurrentSince May 27, 2022 Accepting new patients
Fairview Express Care CurrentSince Jun 27, 2022 Accepting new patients
Fairview Clinics CurrentSince May 27, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

909 Fulton St SE
Ste 300
Minneapolis, MN 55455
Phone (612) 626-3636

420 Delaware St SE
#D410
Minneapolis, MN 55455

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: amattson383894@fairview.direct-ci.com

Organizations & group practices 17

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 17

Hospital & facility affiliations 3

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1619524659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC D-410",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.