EBTISAM WAIS
NPI 1013685098
Physician Assistant in Saint Paul, MN

Q: What is Ebtisam Wais's NPI number?

The NPI number for Ebtisam Wais is 1013685098. It was assigned to this individual provider in the NPPES registry on September 2, 2021.

Q: What is Ebtisam Wais's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ebtisam Wais was last updated on April 4, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 02, 2021PECOS EnrolledAccepts Medicare Assignment

640 JACKSON ST, SAINT PAUL, MN 55101(651) 254-3456 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 4, 2024, Oct 20, 2023, Oct 3, 2023 (3 updates tracked since 2023).

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About Ebtisam Wais NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBTISAM WAIS (NPI 1013685098) is an individual physician assistant in Saint Paul, Minnesota, licensed in Minnesota (14700) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Lakeview Memorial Hospital, and maintains a secondary practice location in Stillwater.

NPPES Registry Identity

NPI1013685098

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameEBTISAM WAIS

Location Address640 JACKSON STSaint Paul, MN 55101-2502

Mailing Address640 Jackson StSaint Paul, MN 55101-2502

Phone(651) 254-3456

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 2, 2021

Last NPPES UpdateApril 4, 20243 updates tracked since enumeration

NPPES CertifiedApril 4, 2024

✔ NPI 1013685098 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 14700

Definition

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.

640 JACKSON ST, Saint Paul, MN 55101

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Secondary Practice Location 1

Location 1927 Churchill St WStillwater, MN 55082-6605 · Phone (651) 430-4529

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ebtisam Wais is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729420922

PECOS Enrollment IDI20240520001667

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lakeview Memorial Hospital

Acute Care Hospitals · Stillwater, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number240066

Location927 West Churchill StreetStillwater, MN 55082 · Washington County

Emergency services Birthing friendly

Regions Hospital

Acute Care Hospitals · Saint Paul, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240106

Location640 Jackson StreetSaint Paul, MN 55101 · Ramsey County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WOJCIECH KRASZKIEWICZ M.D.

Internal Medicine