Avery Grace Macintosh, is a
Physician Assistant based in Mahtomedi, Minnesota. Avery Grace Macintosh is licensed to practice in * (Not Available) (license number ) and her current practice location is
1040 Summit Ave, Mahtomedi, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(651) 815-3171.
NPI number for Avery Grace Macintosh is 1609633510 and her current mailing address is 1040 Summit Ave, Mahtomedi, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1609633510.
Provider's Profile
| Full Name | Avery Grace Macintosh |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 1040 Summit Ave, Mahtomedi, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1609633510
- Provider Enumeration Date: 03/06/2024
- Last Update Date: 03/06/2024
Medical Identifiers
Medical identifiers for Avery Grace Macintosh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609633510 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Avery Grace Macintosh is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Avery Grace Macintosh,
1040 Summit Ave,
Mahtomedi, MN 55115-1544
Ph: (651) 815-3171 | Avery Grace Macintosh,
1040 Summit Ave,
Mahtomedi, MN 55115-1544
Ph: (651) 815-3171 |
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