Mariah Rae Hanson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12527 Issued in MN

Practice address

9550 Upland LN N Ste 100
Maple Grove, MN 55369-4482

Phone

(763) 537-6000

Fax

(763) 537-6666

NPI assigned

Sep 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mariah.eystad.p21@direct.painphysicians.nextgenshare.com

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.

• CH Specialty Services MN PC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1841999158
  Medicare reassignment
• Curana Health of Minnesota PLLC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1083365084
  Medicare reassignment
• Mngi Digestive Health, P.a.

  • Gastroenterology Physician
  • Minneapolis, MN
  • NPI 1609804541
  Medicare reassignment
• CH Specialty Services Wi SC

  • Internal Medicine Physician
  • Hartford, WI
  • NPI 1063115319
  Medicare reassignment
• Curana Health of Wisconsin Inc

  • Internal Medicine Physician
  • Hartford, WI
  • NPI 1699407890
  Medicare reassignment

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1659890762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW STE 220",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554333046",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 UPLAND LN N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694482",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 E Nicollet Blvd Ste 245",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553376782",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2104 Northdale Blvd NW Ste 220",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554333046",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7400 France Ave S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354738",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MARIAH",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7695-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Simone Hanson, MSW
• Gary D Hanson, LMFT
• Jadelyn Hanson, MSW, LGSW
• Joy A Hanson, LMFT
• Julie Diane Hanson, PHARM D
• Melissa Hanson
• Steven Dale Hanson
• Alishba Haq, PHARMD
• Ross Andrew Hardman, MS, LPCC
• Jamie Harmala, PTA

• Physician Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.