Madeline Anastasia Janke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1175003 Issued in WI

Practice address

14001 Ridgedale Dr Ste 100
Minnetonka, MN 55305-1781

Phone

(715) 828-1236

NPI assigned

Jan 5, 2022

Last updated

Jan 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wayzata Children's Clinic P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1023081577
  NPD

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1780345462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 S LOWES CREEK RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017404",
            "telephone_number": "715-828-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "715-828-1236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9325 Upland Ln N Ste 111",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694437",
            "country_code": "US",
            "telephone_number": "763-324-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANKE",
        "first_name": "MADELINE",
        "middle_name": "ANASTASIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1175003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malika Tapree Jager
• Victoria Grace Jaimes
• Kristin Buckner Jakubowski
• Liban Jama
• Kristin Margaret Janke, NP
• Colleen Kay O'Brien Janssen, M.S., CCC-SLP
• Jeana Lee Jarvis, ARNP
• Elizabeth Anne Javinsky, MA, LP
• Nicole Marie Jenabzadeh, CNP
• Kellan Matthews Jenkins, LPC

• Physician Assistant in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.