Individual provider Active NPI

Mia Wintheiser, MD

  • Psychiatry Physician
  • Saint Paul, MN
National Provider Identifier
1871851899
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
61243 Issued in MN
Practice address
1919 University Ave W
Saint Paul, MN 55104-3453
Phone
(651) 266-7914
NPI assigned
Apr 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 61243 MN Primary

Addresses

Primary practice location

1919 University Ave W
Saint Paul, MN 55104-3453

Mailing address

1919 University Ave W
Saint Paul, MN 55104-3453

Other practice location 1

1550 Utica Ave S Ste 450
Saint Louis Park, MN 55416-3678
Phone (952) 856-8452

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200526001616 MN Practitioner - Psychiatry 5395043236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamm Memorial Psychiatric ClinicGroup PAC ID 8426000340, 13 clinicians

Practice addresses (Care Compare)

10 River Park PLZ
Suite 710
Saint Paul, MN 55107-1223
Phone (651) 224-0614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61243MNMDPsychiatry Physician
24544MNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamm Memorial Psychiatric Clinic CurrentSince Mar 22, 2024 Accepting new patients
West Central Counseling LLC PastSince Jun 6, 2021 Accepting new patients
Marie Casey Olseth, MD, LLC Past Accepting new patients

Locations

10 River Park Plz
Ste 710
Saint Paul, MN 55107
Phone (651) 224-0614

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871851899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043453",
            "telephone_number": "651-266-7914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Utica Ave S Ste 450",
            "address_purpose": "LOCATION",
            "city": "Saint Louis Park",
            "state": "MN",
            "postal_code": "554163678",
            "country_code": "US",
            "telephone_number": "952-856-8452",
            "fax_number": "952-746-4383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTHEISER",
        "first_name": "MIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "61243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.