Robert J Niles, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10827 Issued in MN

Practice address

265 Griffin St. East
Amery, WI 54001-1439

Phone

(715) 268-8000

Fax

(715) 268-0311

NPI assigned

Sep 28, 2010

Last updated

Jun 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rniles206080@fairview.direct-ci.com

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  dba Fairview Clinics-Lino Lakes

  • Primary Care Clinic/Center
  • Lino Lakes, MN
  • NPI 1538313796
  NPD
• Fairview Express Care

  dba Fairview Andover Clinic (Eyewear)

  • Eyewear Supplier
  • Andover, MN
  • NPI 1356524540
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • Family Medicine Physician
  • Wyoming, MN
  • NPI 1417037896
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  dba Fairview Northland Hospital

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  NPD

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1639488406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST. EAST",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011439",
            "telephone_number": "715-268-8000",
            "fax_number": "715-268-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST. EAST",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011439",
            "telephone_number": "715-268-8000",
            "fax_number": "715-268-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2713-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639488406",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639488406",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Christine Mueller
• Mickey Mason Muller, DNP
• Municipal Ambulance Service Inc. (Amery Area EMS)
• Alexandra E Nagel
• Logan Narges
• Jill L. Norstrem, RD
• Northwest Journey - Amery
• Northwestern Municipal EMS, Inc.
• Cindy L O'Keefe, MSW
• Enyioma Chukwuzurum Okechukwu, M.D.

• Physician Assistant in Amery, WI
• Providers in Amery, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.