SIMON LOUIS MAZZA PA-C, MSPAS
NPI 1669043360
Physician Assistant in Minneapolis, MN

Active since July 05, 2021PECOS EnrolledAccepts Medicare Assignment
1415 LILAC DR N STE 190, MINNEAPOLIS, MN 55422(763) 267-8701 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 11, 2023, Nov 16, 2021, Jul 5, 2021 (3 updates tracked since 2021).

About Simon Louis Mazza Pa-c, Mspas NPPES

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

SIMON LOUIS MAZZA PA-C, MSPAS (NPI 1669043360) is an individual physician assistant in Minneapolis, Minnesota and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1669043360
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSIMON LOUIS MAZZACredential: PA-C, MSPAS
Location Address1415 LILAC DR N STE 190Minneapolis, MN 55422-4544
Mailing Address1415 Lilac Dr N Ste 190Minneapolis, MN 55422-4544 · (763) 297-8701
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 5, 2021
Last NPPES UpdateJanuary 11, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2023
NPI 1669043360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
1415 LILAC DR N STE 190, Minneapolis, MN 55422

Accepted 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

Simon Louis Mazza Pa-c, Mspas 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 ID9234520545
PECOS Enrollment IDI20211221002204
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
614 services81 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
277 services64 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
92 services49 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
42 services25 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
36 services36 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
26 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240053
Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County
Emergency services Birthing friendly

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240080
Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 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.

Family Medicine (Geriatric Medicine)
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Family Medicine
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner (Family)
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner (Gerontology)
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner (Adult Health)
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422
Nurse Practitioner (Gerontology)
1415 LILAC DR N STE 190
GOLDEN VALLEY, MN 55422

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 Simon Mazza's NPI number?

The NPI number for Simon Mazza is 1669043360. It was assigned to this individual provider in the NPPES registry on July 5, 2021.

Where is Simon Mazza located?

Simon Mazza practices at 1415 Lilac Dr N Ste 190, Minneapolis, MN 55422. The listed phone number is (763) 267-8701.

What is Simon Mazza's specialty?

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

Is Simon Mazza enrolled in Medicare?

Yes. Simon Mazza is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Simon Mazza accept?

Health plans from Medica list Simon Mazza 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.

Is Simon Mazza affiliated with any hospitals?

According to CMS data, Simon Mazza is affiliated with Park Nicollet Methodist Hospital and M Health Fairview University Of Mn.

When was this NPI record last updated?

The NPPES record for Simon Mazza was last updated on January 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.