MALLORI WALTERS PA
NPI 1831556125
Physician Assistant in St Louis Park, MN

Q: What is Mallori Walters's NPI number?

The NPI number for Mallori Walters is 1831556125. It was assigned to this individual provider in the NPPES registry on January 19, 2016.

Q: What is Mallori Walters'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 Mallori Walters was last updated on April 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since January 19, 2016PECOS EnrolledAccepts Medicare Assignment

3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416(952) 883-1000 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 2, 2020, Jun 30, 2016, Jan 19, 2016 (3 updates tracked since 2016).

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About Mallori Walters Pa NPPES

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

MALLORI WALTERS PA (NPI 1831556125) is an individual physician assistant in St Louis Park, Minnesota, licensed in Minnesota (12110) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1831556125

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMALLORI WALTERSCredential: PA

Location Address3850 PARK NICOLLET BLVDSt Louis Park, MN 55416-2527

Mailing Address8170 33rd Ave S, Po Box 1309 Mail Stop 21110qMinneapolis, MN 55425-4516

Phone(952) 883-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJanuary 19, 2016

Last NPPES UpdateApril 2, 20203 updates tracked since enumeration

NPPES CertifiedApril 2, 2020

✔ NPI 1831556125 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 · 12110

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.

3850 PARK NICOLLET BLVD, St Louis Park, MN 55416

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, 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

Mallori Walters Pa 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 ID7113217951

PECOS Enrollment IDI20160607000244

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 8

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

157 services113 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

114 services94 patients

Insertion of temporary bladder tube 51701

This procedure involves placing a small tube into your lower abdomen to help drain urine from your bladder. It's a temporary measure, often used when normal urination is not possible. The tube remains in place until you can urinate on your own again.

82 services50 patients

Pessary, reusable, non rubber, any type A4562

A pessary is a device placed in the body to support areas that have dropped due to age or childbirth. It's made of non-rubber material. It's inserted and removed by a healthcare professional. Regular check-ups are needed to ensure comfort and proper function.

25 services20 patients

Fitting and insertion of vaginal support device 57160

A vaginal support device is a medical tool used to provide support to pelvic organs. During the procedure, a healthcare professional will gently place the device into the appropriate area. This is typically done in a clinical setting and can help with various health conditions.

23 services19 patients

Surgical repair of vaginal defect using an endoscope 57425

This procedure involves the use of a special instrument, an endoscope, to help fix an issue within your body. It's a minimally invasive method, meaning less discomfort and quicker recovery compared to traditional surgery.

16 services15 patients

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 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.

ELISABETH JEAN MCCLEAN MD

Family Medicine