Scott Marshall Schmaedeke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10816 Issued in MN

Practice address

1155 Ford Rd Ste B
St Louis Park, MN 55426-1115

Phone

(952) 378-1800

Fax

(952) 378-1714

NPI assigned

Jun 29, 2010

Last updated

Jul 21, 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 1

Addresses

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  Medicare reassignment Care Compare group
• Medicine Lake Consultation Group,PLLC

  dba lakes consultation group

  • Psychiatry Physician
  • St Louis Park, MN
  • NPI 1881753564
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710298336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST STE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164597",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 FORD RD STE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261115",
            "telephone_number": "952-378-1800",
            "fax_number": "952-378-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3366 Oakdale Ave N",
            "address_2": "Suite 608",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222948",
            "country_code": "US",
            "telephone_number": "763-520-7700",
            "fax_number": "763-520-7776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMAEDEKE",
        "first_name": "SCOTT",
        "middle_name": "MARSHALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara L Schlattman
• Jamie Rose Schlies, CCC-SLP
• Tracy Ann-Voltin Schloemer, M.S
• Schlutter & Associates LLC
• Lois Cochrane Schlutter, PHD LP
• Brittany Schmid
• Brooke E Schmidt, M.A.
• Heather Lynn Schmidt, OTR/L
• Jamie Lynn Schmidt, PT
• Kali Lorene Schmidt, LPCC, LADC

• Physician Assistant in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Physician Assistant in Minnesota

• 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.
• 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.