BENJAMIN JAMES STASIK (NPI# 1013277052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013277052 |
| Entity Type | Individual |
| Full Name | BENJAMIN JAMES STASIK |
| Credential | PA-C |
| Practice Address |
560 S Maple St Suite 200 Waconia MN 55387-1733 |
| Mailing Address |
4200 Dahlberg Dr Suite 300 Golden Valley MN 55422-4840 |
| Practice Telephone | 9524422163 |
| Practice Fax Number | 9524425903 |
| Mailing Telephone | 9525125600 |
| Mailing Fax Number | 9525125651 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2016-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 11149 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
560 S MAPLE ST SUITE 200 |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750379178 | Cheryl A Hansen | Obstetrics & Gynecology | 560 S Maple St, Suite 130, Waconia, MN 55387-1733 | 2005-10-10 |
| 1790339497 | Dana Lee Cox | Occupational Therapist | 560 S Maple St, Waconia, MN 55387-1733 | 2019-07-31 |
| 1548828700 | Lindsay Marie Getten | Specialist/Technologist | 560 S Maple St, Waconia, MN 55387-1733 | 2019-06-03 |
| 1225422819 | Jeffrey Chrest | Specialist/Technologist | 560 S Maple St, Suite 210, Waconia, MN 55387-1733 | 2015-03-23 |
| 1346656089 | Shawn Johnson | Advanced Practice Midwife | 560 S Maple St, Suite 130, Waconia, MN 55387 | 2014-07-02 |
| 1376955971 | Matthew Ray Bennett | Physician Assistant | 560 S Maple St, Suite 200, Waconia, MN 55387-1733 | 2014-05-30 |
| 1043636145 | Meghan M Kolumbus | Specialist/Technologist | 560 S Maple St, Suite 200, Waconia, MN 55387-1733 | 2014-03-13 |
| 1043566003 | Laurie K. Grotzinger | Physician Assistant | 560 S Maple St, Suite 400, Waconia, MN 55387-1733 | 2012-07-27 |
| 1922300979 | Jina M Burman | Physical Therapist | 560 S Maple St, Suite 200, Waconia, MN 55387-1733 | 2010-11-24 |
| 1417276304 | Ryan J. Bakko | Physician Assistant | 560 S Maple St, Suite 200, Waconia, MN 55387-1733 | 2010-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| 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 |
|---|---|---|---|---|
| 1679595052 | Victoria Lea Jones | Physician Assistant | 875 E Main St, Waconia, MN 55387-1081 | 2006-07-24 |
| 1447880612 | Matthew Carl Lund | Physician Assistant | 560 S Maple St Ste 200, Waconia, MN 55387-1757 | 2020-01-16 |
| 1609417351 | Cody Ray Plaisance | Physician Assistant | 560 S Maple St Ste 200, Waconia, MN 55387-1757 | 2019-10-03 |
| 1427561802 | Ashley Sivanich | Physician Assistant | 424 W State Highway 5, Waconia, MN 55387-1723 | 2017-11-08 |
| 1376999482 | Margaret Kennealy | Physician Assistant | 424 W Highway 5, Waconia, MN 55387-1723 | 2016-05-06 |
| 1639429681 | Adam Kent Scofield | Physician Assistant | 560 S Maple St Ste 200, Waconia, MN 55387-1757 | 2012-09-18 |
| 1407101538 | Mitchell John Fogal | Physician Assistant | 560 S Maple St Ste 200, Suite 200, Waconia, MN 55387-1757 | 2012-07-15 |
| 1598071235 | Chelsea Marie Eernisse | Physician Assistant | 500 S Maple St, Waconia, MN 55387-1752 | 2010-08-19 |
| 1861707556 | Tiffany Jean Armstrong | Physician Assistant | 875 E Main St, Waconia, MN 55387-1081 | 2010-08-18 |
| 1124286901 | Elizabeth Anne Radke | Physician Assistant | 500 S Maple St, Waconia, MN 55387-1752 | 2008-05-28 |
| Find all providers in WACONIA | ||||
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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.