Individual provider Active NPI

Andrea Renae Wynands, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1932866423
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14480 Issued in MN
Practice address
420 E 1St St
Duluth, MN 55805-1901
Phone
(218) 786-8364
NPI assigned
Nov 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 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 14480 MN Primary

Addresses

Primary practice location

420 E 1St St
Duluth, MN 55805-1901

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

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
I20230609002419 MN Practitioner - Physician Assistant 2668839465 Reassigns benefits to 1 organization

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
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

402 E 2ND St
Duluth, MN 55805-1906
Phone (218) 786-4000

420 E 1St St
Duluth, MN 55805-1901
Phone (218) 786-8364

502 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

530 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14480MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 3, 2023 Accepting new patients
The Duluth Clinic LTD CurrentSince Jul 3, 2023 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

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

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

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 2

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": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1932866423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051901",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNANDS",
        "first_name": "ANDREA",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.