Individual provider Active NPI

Hannah Marie Janzig, PA-C

  • Physician Assistant
  • Blaine, MN
National Provider Identifier
1992493886
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15001 Issued in MN
Practice address
4181 108TH Ave NE
Blaine, MN 55449-7439
Phone
(763) 581-0555
Fax
(763) 581-0510
NPI assigned
Apr 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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 15001 MN Primary

Addresses

Primary practice location

4181 108TH Ave NE
Blaine, MN 55449-7439

Mailing address

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (763) 581-0555

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
I20241008000896 MN Practitioner - Physician Assistant 4789115205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

15450 Hwy 7
Minnetonka, MN 55345-3522

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (651) 430-3800

800 Freeport Ave NW
Elk River, MN 55330-2723
Phone (763) 581-2273

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Oct 1, 2024 Accepting new patients
North Memorial Health Care CurrentSince Oct 1, 2024 Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1992493886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 108TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497439",
            "telephone_number": "763-581-0555",
            "fax_number": "763-581-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 108TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497439",
            "telephone_number": "763-581-0555",
            "fax_number": "763-581-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANZIG",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.