Active NPI
Andrew William Wittchow, PA-C
- Physician Assistant
- Eden Prairie, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15130
- Practice address
- 965 Prairie Center Dr Ste 200
Eden Prairie, MN 55344-3671 - Phone
- (952) 995-8780
- NPI assigned
- Sep 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15130 | MN | Primary |
Addresses
Primary practice location
965 Prairie Center Dr Ste 200
Eden Prairie, MN 55344-3671
Mailing address
3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16800 37TH PL N
Plymouth, MN 55446-2805
Phone (763) 520-7870
3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300
4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000
5601 96TH Ave N
Brooklyn Park, MN 55443-4505
Phone (763) 786-9543
820 Village Way
Waconia, MN 55387-4612
9630 Grove Cir N
Suite 200
Maple Grove, MN 55369-3492
Phone (763) 520-7870
965 Prairie Ctr Dr
Eden Prairie, MN 55344-3671
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Past | Accepting new patients | |
| St. Croix Orthopaedics, PA | Past | Accepting new patients |
Locations
11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600
1000 W 140th St
Unit 201
Burnsville, MN 55337
Phone (952) 808-3000
2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600
9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580
3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000
16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707
3545 Highway 61 N
Vadnais Heights, MN 55110
820 Village Way
#200
Waconia, MN 55387
4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076
Interoperability endpoints
- awittchow680247@direct.novanthealth.org
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
- Durable Medical Equipment & Medical Supplies
- Hudson, WI
- NPI 1568840916
-
- Specialist
- Oak Park Heights, MN
- NPI 1255337945
-
- Durable Medical Equipment & Medical Supplies
- River Falls, WI
- NPI 1144608589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735603200000",
"number": "1780054254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 AMERICAN BLVD W STE 300",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314442",
"telephone_number": "952-512-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 PRAIRIE CENTER DR STE 200",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443671",
"telephone_number": "952-995-8780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTCHOW",
"first_name": "ANDREW",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-28",
"last_updated": "2024-12-31",
"certification_date": "2024-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "15130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.