Mikaela J Daniels, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13073 Issued in MN

Practice address

790 W 66TH St
Richfield, MN 55423-2203

Phone

(612) 873-6963

NPI assigned

Jul 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Physician Assistant

Education

University of Wisconsin School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Hennepin Healthcare System, Inc

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  Medicare reassignment Care Compare group
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1821149964
  Medicare reassignment
• Hennepin Healthcare System Inc

  • Specialty Pharmacy
  • Minneapolis, MN
  • NPI 1619567625
  NPD
• Hennepin Healthcare System, Inc

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1710313895
  NPD
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1043187289
  NPD
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1104977255
  NPD
• Hennepin Faculty Associates

  • General Practice Physician
  • Minneapolis, MN
  • NPI 1063459485
  NPD (past)

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

• Hennepin Healthcare System, Inc

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1407897309
  Care Compare affiliation

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1790338754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 W 66TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232203",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MIKAELA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "13073",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Custom RX LLC
• Rebecca M. Dahlberg, M.D.
• Ambiyo Dakane
• Damascus Way
• Kirsten Louise Daniels, AU.D.
• Breana Lynn Daoust I
• Brooke Noelle Darst Rice, PT
• Sara Bernadette Dauphinais, PA-C
• Christina Davenport
• Julie Kersti Davenport, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.