Individual provider Active NPI

James R Snyder, PA

  • Physician Assistant
  • Maplewood, MN
National Provider Identifier
1962470302
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8918 Issued in MN
Practice address
1655 Beam Ave
Suite 302
Maplewood, MN 55109-1163
Phone
(651) 232-7831
Fax
(651) 232-7826
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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 8918 MN Primary

Addresses

Primary practice location

1655 Beam Ave
Suite 302
Maplewood, MN 55109-1163

Mailing address

11901 Lofton Ave S
Hastings, MN 55033-8408
Phone (651) 438-2899

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
I20041203000776 MN Practitioner - Physician Assistant 3577529239 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carris Health LLC CurrentSince Apr 1, 2024 Accepting new patients
Fairview Health Services CurrentSince Aug 13, 2012 Accepting new patients
Centracare Clinic CurrentSince Dec 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Aug 13, 2012 Accepting new patients
Centracare Clinic CurrentSince Dec 1, 2019 Accepting new patients
Carris Health LLC CurrentSince Apr 1, 2024 Accepting new patients
Centracare Clinic Past Accepting new patients
Fairview Express Care Past Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: jsnyder286338@fairview.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1962470302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 LOFTON AVE S",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550338408",
            "telephone_number": "651-438-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BEAM AVE",
            "address_2": "SUITE 302",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091163",
            "telephone_number": "651-232-7831",
            "fax_number": "651-232-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "8918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.