Individual provider Active NPI

Haley Mae Faynik, PA-C

  • Physician Assistant
  • Baxter, MN
National Provider Identifier
1881369676
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14390 Issued in MN
Practice address
13060 Isle Dr
Baxter, MN 56425-8331
Phone
(218) 828-2880
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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 14390 MN Primary

Addresses

Primary practice location

13060 Isle Dr
Baxter, MN 56425-8331

Mailing address

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 828-2880

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
I20230327002671 MN Practitioner - Physician Assistant 0345614657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

301 2ND Ave NW
Staples, MN 56479-3336
Phone (218) 894-7870

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14390MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Medical Center CurrentSince Apr 10, 2023 Accepting new patients
St Joseph'S Medical Center CurrentSince Apr 10, 2023 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 29, 2024 Accepting new patients
The Duluth Clinic LTD CurrentSince Apr 29, 2024 Accepting new patients
St. Joseph'S Medical Center Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

680 Pillsbury St N
Pillager, MN 56473
Phone (218) 746-4527

Organizations & group practices 6

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 10

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1881369676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 ISLE DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258331",
            "telephone_number": "218-828-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 ISLE DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258331",
            "telephone_number": "218-828-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYNIK",
        "first_name": "HALEY",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.