Molly Amundson, PA-C
Individual provider Active NPI Physician Assistant · North St Paul, MN
NPI 1730724980 · NPPES record last updated Jun 27, 2023
Key facts
- NPI
- 1730724980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 13216 (MN)
- Practice address
- 2601 Centennial Dr Ste 100
North St Paul, MN 55109-3087 - Phone
- (657) 777-7414
- Fax
- (651) 748-5839
- NPI assigned
- Nov 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Healthservices Minnesota PA
Practice addresses (Care Compare)
2601 Centennial Dr
Suite 100
North St Paul, MN 55109-3087
Phone (651) 788-4444
Hospital & facility affiliations
- M Health Fairview University of MN Medical Center
- M Health Fairview St John'S Hospital
- M Health Fairview Woodwinds Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200102000897 | MN | Practitioner - Physician Assistant | 2466886288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13216 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthservices Minnesota, P.a. | Current |
Accepting new patients | |
| East Metro Family Practice, P.a. | Past | Accepting new patients | |
| Family Healthservices Minnesota, P.a. | Past | Accepting new patients |
Locations
2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414
2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572
Interoperability endpoints
- molly.amundson@entira.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13216 | MN | Yes |
Addresses
Primary practice location
2601 Centennial Dr Ste 100
North St Paul, MN 55109-3087
Mailing address
2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572
Other providers in North St Paul, MN
- Emily Aiello
- Courtney Elizabeth Alford
- Matthew Amspoker
- Candace Jean Anderson
- Jason Jay Arndt
- Zewdu Ayenew
- Mark WW Bogel
- Maria Elena Bonilla Reyes
All providers in North St Paul, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.