NPIMap

Individual provider Active NPI

Angela L. Reichart, PA

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1962428730
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9854 Issued in MN
Practice address
4621 E Superior St
Duluth, MN 55804-2338
Phone
(218) 786-3550
Fax
(218) 525-7487
NPI assigned
Jul 14, 2006
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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 9854 MN Primary

Addresses

Primary practice location

4621 E Superior St
Duluth, MN 55804-2338

Mailing address

7701 York Ave S Ste 300
Edina, MN 55435-5864
Phone (952) 926-6489

Other identifiers 1

IdentifierTypeStateIssuer
579180400MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000218 MN Practitioner - Physician Assistant 4385545235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edina Sports Health and Wellness, PAGroup PAC ID 7012817596, 9 clinicians

Practice addresses (Care Compare)

7701 York Ave S
Suite 300
Edina, MN 55435-5238

7701 York Ave S
Suite 300
Edina, MN 55435-5864
Phone (952) 926-6489

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1962428730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 YORK AVE S STE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355864",
            "telephone_number": "952-926-6489",
            "fax_number": "952-926-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042338",
            "telephone_number": "218-786-3550",
            "fax_number": "218-525-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHART",
        "first_name": "ANGELA",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579180400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.