Active NPI
Madison Jane Wetzel, PA-C
- Physician Assistant
- Bloomington, MN
National Provider Identifier
1801641089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15578
- Practice address
- 4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435 - Phone
- (952) 767-4574
- NPI assigned
- Apr 20, 2024
- Sex
- Female
- 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 | 15578 | MN | Primary |
Addresses
Primary practice location
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Mailing address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 767-4574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15578 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1801641089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 MARKETPOINTE DR STE 100",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554355435",
"telephone_number": "952-767-4574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 MARKETPOINTE DR STE 100",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554355435",
"telephone_number": "952-767-4574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETZEL",
"first_name": "MADISON",
"middle_name": "JANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-20",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "15578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.