TASHEENA BROADNAX
NPI 1033997242
Physician Assistant in Brooklyn Park, MN

Q: What is Tasheena Broadnax's NPI number?

The NPI number for Tasheena Broadnax is 1033997242. It was assigned to this individual provider in the NPPES registry on September 19, 2023.

Q: What is Tasheena Broadnax'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 Tasheena Broadnax was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since September 19, 2023PECOS EnrolledAccepts Medicare Assignment

10000 ZANE AVE N, BROOKLYN PARK, MN 55443(763) 528-6999 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2025, Jun 9, 2024 (2 updates tracked since 2024).

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About Tasheena Broadnax NPPES

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

TASHEENA BROADNAX (NPI 1033997242) is an individual physician assistant in Brooklyn Park, Minnesota, licensed in Minnesota (15206) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1033997242

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameTASHEENA BROADNAX

Location Address10000 ZANE AVE NBrooklyn Park, MN 55443-1400

Mailing Address10000 Zane Ave NBrooklyn Park, MN 55443-1400 · (763) 528-6999

Phone(763) 528-6999

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 19, 2023

Last NPPES UpdateJune 23, 20252 updates tracked since enumeration

NPPES CertifiedJune 23, 2025

✔ NPI 1033997242 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 · 15206

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.

10000 ZANE AVE N, Brooklyn Park, MN 55443

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

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

Tasheena Broadnax 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 ID3577069251

PECOS Enrollment IDI20251001003244

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 55443 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.

HILARY G WILDE RD, CDE

Dietitian, Registered