Individual provider Active NPI

Rebecca Christine Fichtel, PA-C

  • Physician Assistant
  • Wayzata, MN
National Provider Identifier
1821538240
Registry record updated Mar 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12343 Issued in MN
Practice address
250 Central Ave N
Suite #220 & #228
Wayzata, MN 55391-1206
Phone
(952) 993-8250
NPI assigned
Mar 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2017

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 12343 MN Primary

Addresses

Primary practice location

250 Central Ave N
Suite #220 & #228
Wayzata, MN 55391-1206

Mailing address

250 Central Ave N
Suite #220 & #228
Wayzata, MN 55391-1206

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170413001408 MN Practitioner - Physician Assistant 7214213875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospice, Saint Louis Park, MN, CCN 241512
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12343MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince May 22, 2017 Accepting new patients
Park Nicollet Clinic CurrentSince May 22, 2017 Accepting new patients
Park Nicollet Clinic Past Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

250 Central Ave N
Ste 220
Wayzata, MN 55391
Phone (952) 993-8250

250 Central Ave N
Ste 228
Wayzata, MN 55391
Phone (952) 993-8250

250 Central Ave N
Ste 103
Wayzata, MN 55391
Phone (952) 249-2000

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 7

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": "1488585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488585600000",
    "number": "1821538240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N",
            "address_2": "SUITE #220 & #228",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N",
            "address_2": "SUITE #220 & #228",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206",
            "telephone_number": "952-993-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICHTEL",
        "first_name": "REBECCA",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-04",
        "last_updated": "2017-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

Verify at the official NPI Registry.