Misty Schmitz, DC, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12419 Issued in MN

Practice address

2017 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4121

Phone

(763) 757-5615

NPI assigned

Aug 26, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Misty Detraiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952534802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 WILDFLOWER COURT",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "920-889-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334121",
            "telephone_number": "763-757-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "MISTY",
        "credential": "DC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4505-012",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "DETRAIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Kristine Schmitt, RN
• Cari Lynn Schmitt, PA-C
• Jenna Schmitt, PA-C
• Amanda Schmitz, O.D.
• Jillian Schmitz, CNP
• Sarah Beth Schoel, MD
• Karen Michelle Schoumaker, CRNA
• Makenzie Schowalter
• Alexis Gretchen Schreiber, MS
• Lawrence E Schroeder, MD

• Physician Assistant in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.