Individual provider Active NPI

Rachel Louise Pfenning-Wendt, MPH, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1639861628
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-6360
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

3469 Vivian Ave
Shoreview, MN 55126-3851
Phone (651) 249-4746

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
I20240305004085 MN Practitioner - Physician Assistant 4183069776 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Jan 7, 2024 Accepting new patients
Childrens Health Care CurrentSince Jan 7, 2024 Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

18432 Kenrick Ave
Lakeville, MN 55044
Phone (952) 992-6700

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

6060 Clearwater Dr
Ste 220
Minnetonka, MN 55343
Phone (651) 220-6624

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1639861628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 VIVIAN AVE",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551263851",
            "telephone_number": "651-249-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFENNING-WENDT",
        "first_name": "RACHEL",
        "middle_name": "LOUISE",
        "credential": "MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.