Individual provider Active NPI

Marcus J Nielsen, PA

  • Physician Assistant
  • Saint Paul, NE
National Provider Identifier
1821311853
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1506 Issued in NE
Practice address
1113 Sherman St
Saint Paul, NE 68873-1546
Phone
(308) 754-4421
Fax
(308) 754-2303
NPI assigned
Mar 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 1506 NE Primary

Addresses

Primary practice location

1113 Sherman St
Saint Paul, NE 68873-1546

Mailing address

PO Box 406
Saint Paul, NE 68873-0406
Phone (308) 754-4421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20100427000766 NE Practitioner - Physician Assistant 6406983287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard County Medical CenterGroup PAC ID 5698775849, 28 clinicians

Practice addresses (Care Compare)

1113 Sherman St
Saint Paul, NE 68873-1546
Phone (308) 754-4421

PO Box
Suite 406
Saint Paul, NE 68873

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1506NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Howard County Medical Center CurrentSince May 28, 2020 Accepting new patients
Howard County Medical Center CurrentSince May 28, 2020 Accepting new patients
Hastings Internal Medicine Associates PC PastSince May 7, 2023 Accepting new patients
Howard County Medical Center Past Accepting new patients

Locations

1113 Sherman St
Saint Paul, NE 68873
Phone (308) 754-4421

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1821311853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688730406",
            "telephone_number": "308-754-4421",
            "fax_number": "308-754-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 SHERMAN ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731546",
            "telephone_number": "308-754-4421",
            "fax_number": "308-754-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "MARCUS",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-04",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, NE

Sources for this page

Verify at the official NPI Registry.