NPIMap

Individual provider Active NPI

Samuel Heaton, PA

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1740058528
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
913 E 26TH St Ste 600
Minneapolis, MN 55404-4515
Phone
(612) 775-6200
NPI assigned
Dec 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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 Primary

Addresses

Primary practice location

913 E 26TH St Ste 600
Minneapolis, MN 55404-4515

Mailing address

913 E 26TH St Ste 600
Minneapolis, MN 55404-4515
Phone (612) 775-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122002228 MN Practitioner - Physician Assistant 9335591700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

913 E 26TH St
Minneapolis, MN 55404-4515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14765MNMDComputed Tomography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 1, 2024 Accepting new patients
Allina Health System CurrentSince Mar 1, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

675 E Nicollet Blvd
Ste 130
Burnsville, MN 55337
Phone (952) 892-2383

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

2855 Campus Dr
Ste 300
Plymouth, MN 55441
Phone (763) 520-2900

2855 Campus Dr
Ste 600
Plymouth, MN 55441
Phone (612) 333-4822

Interoperability endpoints

  • Direct secure messaging: samuel.heaton.p2@direct.tcspine.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1740058528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 E 26TH ST STE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044515",
            "telephone_number": "612-775-6200",
            "fax_number": "612-775-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 E 26TH ST STE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044515",
            "telephone_number": "612-775-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "SAMUEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-12",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.