NPIMap

Individual provider Active NPI

Frederick E Demeuse, PAC

  • Physician Assistant
  • Eden Prairie, MN
National Provider Identifier
1760434211
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9865 Issued in MN
Practice address
7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone
(612) 573-2200
Fax
(612) 573-2274
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 9865 MN Primary

Addresses

Primary practice location

7595 Anagram Dr
Eden Prairie, MN 55344-7399

Mailing address

7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone (612) 573-2200

Other practice location 1

6545 E Fish Lake Rd
Maple Grove, MN 55369-6005
Phone (612) 695-9409

Other identifiers 1

IdentifierTypeStateIssuer
527430300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040228000241 MN Practitioner - Physician Assistant 2466349139 Reassigns benefits to 7 organizations
I20241213002288 ND Practitioner - Physician Assistant 2466349139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians
Consulting Radiologists LTDGroup PAC ID 7719899962, 77 clinicians
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

100 State Ave
Faribault, MN 55021-6337
Phone (507) 334-3921

1324 5TH St N
New Ulm, MN 56073-1514
Phone (507) 354-2111

1455 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 403-3000

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

200 State Ave
Faribault, MN 55021-6339
Phone (507) 332-4855

2000 N Ave
Northfield, MN 55057-1498
Phone (507) 646-1000

2855 Campus Dr
Suite 400
Plymouth, MN 55441-2659
Phone (763) 577-7400

301 S Hwy 65
Mora, MN 55051-1899
Phone (320) 679-1212

407 W 66TH St
Richfield, MN 55423-2304
Phone (612) 798-8800

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

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

5203 Vernon Ave S
Edina, MN 55436-2106
Phone (952) 925-2200

6525 France S Ave
Suite 110
Edina, MN 55435-2158
Phone (952) 915-4320

7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone (612) 573-2200

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

  • New Ulm Medical Center Hospital, New Ulm, MN, CCN 241378
  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104
  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Allina Health Faribault Medical Center Hospital, Faribault, MN, CCN 240071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1816WIMDNurse Practitioner
9865MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sibley Medical Center CurrentSince Nov 1, 2014 Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Apr 26, 2021 Accepting new patients
St. Francis Regional Medical Center CurrentSince Jul 1, 2023 Accepting new patients
Mercy Home Care CurrentSince Dec 1, 2024 Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Ridgeview Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Mercy Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Allina Health System Past Accepting new patients
Northern Lights Clinic SC Past Accepting new patients

Locations

3369 Solutions Ctr
Chicago, IL 60677

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

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1760434211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6545 E Fish Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553696005",
            "country_code": "US",
            "telephone_number": "612-695-9409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMEUSE",
        "first_name": "FREDERICK",
        "middle_name": "E",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527430300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.