Individual provider Active NPI

May Mua, PA

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1770559643
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9664 Issued in MN
Practice address
401 Phalen Blvd
Saint Paul, MN 55130
Phone
(651) 254-7820
Fax
(651) 254-7827
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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 9664 MN Primary

Addresses

Primary practice location

401 Phalen Blvd
Saint Paul, MN 55130

Mailing address

8170 33Rd Avenue South
Ms 21110Q
Bloomington, MN 55425-4516
Phone (651) 254-7820

Other practice location 1

8170 33rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (952) 883-7172

Other identifiers 1

IdentifierTypeStateIssuer
146309800MedicaidMN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050105000430 MN Practitioner - Physician Assistant 6901854173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9664MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Touching Lives Adult Day Care, LLC Current Accepting new patients
Group Health, Inc. CurrentSince Oct 31, 2004 Accepting new patients
Group Health, Inc. CurrentSince Oct 31, 2004 Accepting new patients
Group Health, Inc. Past Accepting new patients
Qwik Urgent Care Clinic PastSince Sep 1, 2007 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Interoperability endpoints

  • Direct secure messaging: may.mua.1@12803.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1770559643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVENUE SOUTH",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-7820",
            "fax_number": "651-254-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55130",
            "telephone_number": "651-254-7820",
            "fax_number": "651-254-7827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8170 33rd Ave S",
            "address_2": "MS 21110Q",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554254516",
            "country_code": "US",
            "telephone_number": "952-883-7172",
            "fax_number": "952-883-5395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUA",
        "first_name": "MAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146309800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.