Ethan Conroy, PAC in Saint Paul, MN - Medicare Physician Assistant

Ethan Conroy, PAC is a medicare enrolled "Physician Assistant - Surgical" in Saint Paul, Minnesota. His current practice location is 17 Exchange St W, Suite 222, Saint Paul, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 224-7854.

Ethan Conroy is licensed to practice in Minnesota (license number 9849) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1023089547.

Contact Information

	Ethan Conroy, PAC
	17 Exchange St W, Suite 222, Saint Paul, MN 55102-1045
	(651) 224-7854
	Not Available

Map and Direction

Provider's Profile

Full Name	Ethan Conroy
Gender	Male
Speciality	Physician Assistant - Surgical
Location	17 Exchange St W, Saint Paul, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023089547
Provider Enumeration Date: 02/01/2006
Last Update Date: 10/30/2014

Medicare PECOS Information:

PECOS PAC ID: 0042298325
Enrollment ID: I20190201002352

Medical Identifiers

Medical identifiers for Ethan Conroy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023089547	NPI	-	NPPES
923192700	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	9849 (Minnesota)	Secondary
363AS0400X	Physician Assistant - Surgical	9849 (Minnesota)	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. Ethan Conroy is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan Conroy, PAC 1516 Holton St, Saint Paul, MN 55108-2326 Ph: (651) 644-3119	Ethan Conroy, PAC 17 Exchange St W, Suite 222, Saint Paul, MN 55102-1045 Ph: (651) 224-7854

Reviews and Comments

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Ethan Conroy, PAC - Medicare Physician Assistant in Saint Paul, MN