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CARLY JO HENNEK PA-C
NPI 1023824406
Physician Assistant in Roseville, MN

Active since December 10, 2024PECOS Enrolled
2720 FAIRVIEW AVE N STE 200, ROSEVILLE, MN 55113(651) 633-6883(651) 331-3459 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 10, 2025, Dec 10, 2024 (2 updates tracked since 2024).

About Carly Jo Hennek Pa-c NPPES

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

CARLY JO HENNEK PA-C (NPI 1023824406) is an individual physician assistant in Roseville, Minnesota, licensed in Minnesota (15246) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1023824406
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCARLY JO HENNEKCredential: PA-C
Location Address2720 FAIRVIEW AVE N STE 200Roseville, MN 55113-1306
Mailing Address2720 Fairview Ave N Ste 200Roseville, MN 55113-1306 · (651) 633-6883 · Fax (651) 331-3459
Phone(651) 633-6883
Fax(651) 331-3459
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateDecember 10, 2024
Last NPPES UpdateFebruary 10, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2025
✔ NPI 1023824406 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 · 15246
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.
2720 FAIRVIEW AVE N STE 200, Roseville, MN 55113
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carly Jo Hennek Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951821305
PECOS Enrollment IDI20250228000807, I20250319003162
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55113 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.

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.

DR. JAMES ALBERT RAMIREZ M.D.
Pathology (Dermatopathology)
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
TAREEN DERMATOLOGY, P.A.
Dermatology
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
AUSTIN JAMES HENEMAN PA-C
Physician Assistant
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
KELSEY KATHLEEN STRUB
Physician Assistant
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (952) 452-6503
ASHLEY DAVIS
Physician Assistant
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
DR. AAYUSHMA REGMI M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
KATELYN M LANGLIE PA-C
Physician Assistant (Medical)
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883
WAEL S IBRAHIM MD
Pathology (Dermatopathology)
2720 FAIRVIEW AVE N STE 200
ROSEVILLE, MN 55113
Ramsey County (651) 633-6883

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Hennek's NPI number?

The NPI number for Carly Hennek is 1023824406. It was assigned to this individual provider in the NPPES registry on December 10, 2024.

Where is Carly Hennek located?

Carly Hennek practices at 2720 Fairview Ave N Ste 200, Roseville, MN 55113. The listed phone number is (651) 633-6883.

What is Carly Hennek's specialty?

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

Is Carly Hennek enrolled in Medicare?

Yes. Carly Hennek is registered in the Medicare PECOS enrollment system.

What insurance does Carly Hennek accept?

Health plans from Anthem Blue Cross and Blue Shield and HealthPartners list Carly Hennek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carly Hennek was last updated on February 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.