Active NPI
Steven B Vandonselaar, PA-C
- Physician Assistant
- Edina, MN
National Provider Identifier
1659345783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9499
- Practice address
- 7400 France Ave S Ste 100
Edina, MN 55435-4738 - Phone
- (763) 537-6000
- Fax
- (763) 537-6666
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9499 | MN | Primary |
Addresses
Primary practice location
7400 France Ave S Ste 100
Edina, MN 55435-4738
Mailing address
4131 W Loomis Rd Ste 300
Greenfield, WI 53221-2059
Phone (414) 325-7246
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 213628700 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Rochester, MN
- NPI 1922074434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1659345783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 W LOOMIS RD STE 300",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212059",
"telephone_number": "414-325-7246",
"fax_number": "414-325-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 FRANCE AVE S STE 100",
"city": "EDINA",
"state": "MN",
"postal_code": "554354738",
"telephone_number": "763-537-6000",
"fax_number": "763-537-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDONSELAAR",
"first_name": "STEVEN",
"middle_name": "B",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "213628700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.