MATTHEW WEISEMAN (NPI# 1952885931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952885931 |
| Entity Type | Individual |
| Full Name | MATTHEW WEISEMAN |
| Credential | PA-C |
| Practice Address |
5366 386th St Ne North Branch MN 55056-5833 |
| Mailing Address |
2930 11th Ave Evans CO 80620-1011 |
| Practice Telephone | 6516748353 |
| Mailing Telephone | 9703504606 |
| Mailing Fax Number | 9703504645 |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2019-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2930 11th Ave, Evans, CO 806201011 | 9703504606 | 9703504645 |
| Street Address |
5366 386TH ST NE |
| City | NORTH BRANCH |
| State | MN |
| Zip Code | 55056-5833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356653760 | Jenna Lynn Moscherosch | Physician Assistant | 5366 386th St Ne, North Branch, MN 55056-5833 | 2010-07-14 |
| 1366893331 | Jena Labine | Nurse Practitioner | 5366 386th St Ne, North Branch, MN 55056-5833 | 2016-06-30 |
| 1497138465 | Joseph David Lahti | Pharmacist | 5366 386th St Ne, North Branch, MN 55056-5833 | 2015-07-08 |
| 1922486307 | Amy Carlson | Physical Therapist | 5366 386th St Ne, North Branch, MN 55056-5833 | 2015-05-18 |
| 1477964336 | Nicole Anderson | Registered Nurse | 5366 386th St Ne, North Branch, MN 55056-5833 | 2014-05-14 |
| 1972937506 | Tec LLC | Eyewear Supplier (Equipment, not the service) | 5366 386th St Ne, North Branch, MN 55056-5833 | 2013-08-30 |
| 1710321054 | Fairview Pharmacy Services LLC | Pharmacy | 5366 386th St Ne, North Branch, MN 55056-5833 | 2013-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217146 | Joy Solano | Counselor | 38873 14th Ave North, North Branch, MN 55056 | 2015-10-19 |
| 1285072637 | Teresa Ann Dewitt | Registered Nurse | 9208 St Croix Trail, North Branch, MN 55056 | 2013-06-07 |
| 1396074209 | Twin Cities Mobile Chiropractic, P.C. | Clinic/Center | 6754 380th Circle, North Branch, MN 55056 | 2009-12-24 |
| 1811157662 | Shopko Stores Operating Co LLC | Pharmacy | 5630 St Croix Trail, North Branch, MN 55056 | 2008-06-16 |
| 1023171196 | Shawn Timothy Mccullough | Dentist | 6041 Main Street, Suite C, North Branch, MN 55056 | 2006-12-19 |
| 1518050103 | Paula J Rehder | Family Medicine | 6413 Oak Street, North Branch, MN 55056 | 2006-10-02 |
| 1699711614 | Julie A Perreault | Chiropractor | 6361 Main St, No Branch, MN 55056 | 2006-06-20 |
| 1760950307 | Kara H Mireles | Marriage & Family Therapist | 5842 Old Main St, Ste 2,3,4, North Branch, MN 55056 | 2018-11-12 |
| 1134614506 | Jenna Marie Leirmoe | Counselor | 38878 12th Ave, North Branch, MN 55056 | 2018-06-27 |
| 1689835647 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 5630 St Croix Trail, North Branch, MN 55056 | 2008-06-23 |
| Find all providers in zip 55056 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760002752 | Casey Hovland | Physician Assistant | 5278 408th St, North Branch, MN 55056-5278 | 2020-04-20 |
| 1063780187 | Marcella Gutierrez | Physician Assistant | 6413 Oak St, North Branch, MN 55056-5129 | 2011-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1043811870 | Leiah Hoffman | Physician Assistant | 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 | 2020-11-06 |
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1780284844 | Lily Ganz | Physician Assistant | 2737 Huntington Ave, St Louis Park, MN 55416-3917 | 2020-10-28 |
| 1972103000 | Jaclyn Ann Bautch | Physician Assistant | 24721 State Highway 15, Saint Augusta, MN 56301-9211 | 2020-10-28 |
| 1801496047 | Tanner Vaughn Kramp | Physician Assistant | 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 | 2020-10-27 |
| 1497354955 | Sarah Marti | Physician Assistant | 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 | 2020-10-25 |
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1073112009 | Reece Edward Mcevoy | Physician Assistant | 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 | 2020-10-21 |
| 1679189021 | Anne Elizabeth Drabot | Physician Assistant | 4741 Vincent Ave S, Minneapolis, MN 55410-1843 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BRANCH |
| Zip Code | 55056 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.