NPIMap

Individual provider Active NPI

Abigail Nancy Anderson, PA-C

  • Physician Assistant
  • Cloquet, MN
National Provider Identifier
1972149623
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
927 Trettel LN
Cloquet, MN 55720-1345
Phone
(218) 879-1227
NPI assigned
Nov 18, 2019
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 NU Primary

Addresses

Primary practice location

927 Trettel LN
Cloquet, MN 55720-1345

Mailing address

93872 Windemere Way
Sturgeon Lake, MN 55783-3614
Phone (218) 310-7599

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
I20200212000627 MN Practitioner - Physician Assistant 9436585353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

211 W 4TH St
Duluth, MN 55806-2719
Phone (218) 879-1227

927 Trettel LN
Cloquet, MN 55720-1345
Phone (218) 879-1227

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as group
Quality
80.41
Promoting interoperability
80
Improvement activities
40
Cost
53.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Reservation Business Committee CurrentSince Jan 13, 2020 Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

Interoperability endpoints

  • Direct secure messaging: abigail.anderson.p1@direct.fonddulachsd.nextgenshare.com

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1972149623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93872 WINDEMERE WAY",
            "city": "STURGEON LAKE",
            "state": "MN",
            "postal_code": "557833614",
            "telephone_number": "218-310-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ABIGAIL",
        "middle_name": "NANCY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.