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CARLY WITHERELL PA-C
NPI 1750904819
Physician Assistant in Minneapolis, MN

Active since May 24, 2020PECOS Enrolled
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455(612) 884-0600 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 8, 2023, Jul 12, 2023, May 24, 2020 (3 updates tracked since 2020).

About Carly Witherell Pa-c NPPES

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

CARLY WITHERELL PA-C (NPI 1750904819) is an individual physician assistant in Minneapolis, Minnesota and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1750904819
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCARLY WITHERELLCredential: PA-C
Location Address420 DELAWARE ST SEMinneapolis, MN 55455-0341
Mailing Address420 Delaware St SeMinneapolis, MN 55455-0341 · (612) 624-8199
Phone(612) 884-0600
Sole ProprietorYes
Enumeration DateMay 24, 2020
Last NPPES UpdateAugust 8, 20233 updates tracked since enumeration
NPPES CertifiedAugust 8, 2023
✔ NPI 1750904819 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.
420 DELAWARE ST SE, Minneapolis, MN 55455
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Secondary Practice Locations 2

Location 13200 Grand AveDes Moines, IA 50312-4104 · Phone (515) 271-1569
Location 25501 Feltl RdMinnetonka, MN 55343-3944 · Phone (952) 746-0222

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 (PECOS)

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

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

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
20 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55455 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.

KHALID AMIN MD
Pathology (Anatomic Pathology & Clinical Pathology)
420 DELAWARE ST SE, C463 MAYO MEMORIAL BLDG, MAYO MAIL CODE 76
MINNEAPOLIS, MN 55455
Hennepin County (913) 827-3505
MELISSA RICHARDSON PA-C
Physician Assistant
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 273-3000
DR. RAID SAID MOUSA YOUSEF M.D.
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE, MMC 11
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-7911
DR. DAVID YOUNG BALSER MD
Physical Medicine & Rehabilitation
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2661
ALEXANDER TROESTER
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-6483
NIKITHA VOBUGARI MD
Internal Medicine (Hematology & Oncology)
420 DELAWARE ST SE, MMC 480
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-0400
THOMAS HOUGHLAND MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-5589
DR. ANUSHA L GOPALAM MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5454

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 Witherell's NPI number?

The NPI number for Carly Witherell is 1750904819. It was assigned to this individual provider in the NPPES registry on May 24, 2020.

Where is Carly Witherell located?

Carly Witherell practices at 420 Delaware St SE, Minneapolis, MN 55455. The listed phone number is (612) 884-0600.

What is Carly Witherell's specialty?

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

Is Carly Witherell enrolled in Medicare?

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

What insurance does Carly Witherell accept?

Health plans from Medica list Carly Witherell 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 Witherell was last updated on August 8, 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.