RONNEIL AVILES (NPI# 1194275552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194275552 |
| Entity Type | Individual |
| Full Name | RONNEIL AVILES |
| Credential | PA-C |
| Practice Address |
1654 Diffley Rd Eagan MN 55122 |
| Mailing Address |
8170 33rd Ave S # Ms 21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 9528538800 |
| Mailing Telephone | 9528538800 |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2020-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 12209 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3300 Oakdale Ave N, Robbinsdale, MN 554222926 | 7635205200 |
| Street Address |
1654 DIFFLEY RD |
| City | EAGAN |
| State | MN |
| Zip Code | 55122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700858974 | Raina L Young | Family Medicine | 1654 Diffley Rd, Eagan, MN 55122-2237 | 2006-02-02 |
| 1811244809 | Group Health Plan Inc | Durable Medical Equipment & Medical Supplies | 1654 Diffley Rd, Suite 100, Eagan, MN 55122 | 2012-08-08 |
| 1295019388 | Jesse Lee Fladmark | Specialist/Technologist | 1654 Diffley Rd, 100, Eagan, MN 55122-2237 | 2011-10-06 |
| 1356441877 | Michael E Fleischhacker | Chiropractor | 1654 Diffley Rd, Stuite 100, Eagan, MN 55122-2237 | 2006-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| 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 |
|---|---|---|---|---|
| 1295371789 | Kamini Bose Sundar Bose | Physician Assistant | 781 Elrene Ct, Eagan, MN 55123-1233 | 2019-11-20 |
| 1568960292 | Omar Fernandes | Physician Assistant | Healthpartners Eagan Clinic, 1654 Diffley Road Ste 100 Mail Stop 34701a, Eagan, MN 55122-2237 | 2018-01-29 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1649328121 | Jennifer Marie Kulus | Physician Assistant | Fairview Urgent Care - Eagan, 1440 Duckwood Drive, Eagan, MN 55122 | 2007-01-08 |
| 1902875818 | Bryan C Sternberg | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2006-03-14 |
| 1396307450 | Laura Fisher | Physician Assistant | 1400 Corporate Center Curv, Eagan, MN 55121-1373 | 2019-06-28 |
| 1568806958 | Jessica Lynn Cicero | Physician Assistant | 2700 Vikings Cir, Eagan, MN 55121 | 2013-04-29 |
| 1033451232 | Brooke Schroepfer | Physician Assistant | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2013-03-26 |
| 1306149539 | Kathryn Susan Eisenmenger Fuentes | Physician Assistant | 2854 Highway 55, Suite 130, Eagan, MN 55121-2156 | 2010-12-09 |
| 1003135765 | Kathryn Kempe O'morchoe | Physician Assistant | 1185 Town Centre Dr Ste 205, Eagan, MN 55123-1370 | 2010-05-20 |
| Find all providers in EAGAN | ||||
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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.