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Carly Witherell , PA-C

Physician Assistant โ€ข Minneapolis, MN

Active NPI 1750904819 Individual Practitioner Female Practitioner
Practice location in NPPES

420 Delaware St Se
Minneapolis, MN 554550341

Call 6128840600 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

420 Delaware St Se

Minneapolis, MN 554550341

Telephone 6128840600
Organization at the Same NPPES Address or Phone
University Of Minnesota Facility NPI 1730371857

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Des Moines, IA; Minnetonka, MN. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare patients

13 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $1,895 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $1,510 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

15 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$83 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021โ€“2025.

Guide: How to read an Open Payments record

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Carly Witherell has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Carly Witherell as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Minneapolis and Minnesota

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Fewer Medicare Part B services than 90% of clinicians listed under Physician Assistant in Minneapolis, MN (2024, 257 clinicians with data). Median for this group: 133. Middle half: 61 to 249.

Fewer Medicare Part B services than 95% of clinicians listed under Physician Assistant in Minnesota (2024, 2,405 clinicians with data). Median for this group: 192. Middle half: 86 to 384.

Medicare-allowed amount

A lower Medicare-allowed amount than 90% of clinicians listed under Physician Assistant in Minneapolis, MN (2024, 257 clinicians with data). Median for this group: $9,702. Middle half: $4,523 to $18,855.

A lower Medicare-allowed amount than 90% of clinicians listed under Physician Assistant in Minnesota (2024, 2,405 clinicians with data). Median for this group: $13,293. Middle half: $6,209 to $23,808.

Paid by Medicare

A lower Medicare payment amount than 90% of clinicians listed under Physician Assistant in Minneapolis, MN (2024, 257 clinicians with data). Median for this group: $7,651. Middle half: $3,399 to $14,564.

A lower Medicare payment amount than 90% of clinicians listed under Physician Assistant in Minnesota (2024, 2,405 clinicians with data). Median for this group: $9,818. Middle half: $4,558 to $17,894.

Medicare Part D prescriptions

Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Minneapolis, MN (2024, 231 clinicians with data). Median for this group: 156. Middle half: 53 to 589.

Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Minnesota (2024, 2,421 clinicians with data). Median for this group: 226. Middle half: 71 to 825.

Part D drug cost

A lower Part D drug cost than 90% of clinicians listed under Physician Assistant in Minneapolis, MN (2024, 231 clinicians with data). Median for this group: $3,323. Middle half: $483 to $111,748.

A lower Part D drug cost than 90% of clinicians listed under Physician Assistant in Minnesota (2024, 2,421 clinicians with data). Median for this group: $3,260. Middle half: $590 to $83,279.

500 active clinicians are listed under Physician Assistant with a practice address in Minneapolis, MN (4,007 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Minneapolis

21.8% of these 500 clinicians have the CMS telehealth indicator.

70.8% of these 500 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
20 11 $434.00 $94.76

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Levofloxacin Levofloxacin 15 184 $82.58 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-08
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20230825000601

Enrollment State Jurisdiction

MN

PECOS Control ID

2264895192

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

3200 Grand Ave

Des Moines, IA 503124104

Phone: 5152711569

5501 Feltl Rd

Minnetonka, MN 553433944

Phone: 9527460222

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Chiara Andahazy , PA-C

Physician Assistant

NPI 1912558651

Physician Assistant (Certified)

NPI 1326571548

Doctor of Osteopathic Medicine (D.O.)

Sara Fry , PA-C

Physician Assistant

NPI 1679287668

Physician Assistant (Certified)

Ann Maresh , NP

Nurse Practitioner

NPI 1457304206

Nurse Practitioner

Allison Zager

Nurse Practitioner

NPI 1689149031

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
๐Ÿ“
Updated Practice Location August 08, 2023

Registered at 420 DELAWARE ST SE, MINNEAPOLIS, MN 554550341 (Tel: 6128840600)

๐Ÿ“
Updated Business Mailing Address August 08, 2023

Registered at 420 DELAWARE ST SE, MINNEAPOLIS, MN 554550341 (Tel: 6126248199)

๐Ÿ‘ค
Provider Name / Credentials Updated August 08, 2023

Recorded as CARLY WITHERELL, PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2023

Physician Assistant

๐Ÿ“
Updated Practice Location March 25, 2022

Registered at 3200 GRAND AVE, DES MOINES, IA 503124104 (Tel: 5152711569)

โœ…
NPI Profile Active May 24, 2020

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) May 24, 2020

Registered at 5501 FELTL RD, MINNETONKA, MN 553433944 (Tel: 9527460222)

๐Ÿ“
Business Mailing Address (Initial Record) May 24, 2020

Registered at 1509 SOUTHCROSS DR W, BURNSVILLE, MN 553066945 (Tel: 9524919810)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) May 24, 2020

Recorded as CARLY WITHERELL

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 24, 2020

Behavior Technician

๐ŸŸข
Initial NPI Registration & Enumeration May 24, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1750904819
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2020
Last Update: August 08, 2023
Sole Proprietor: Yes

Other Physician Assistants in Minneapolis

All Physician Assistants in Minneapolis

Mailing Address

420 Delaware St Se

Minneapolis, MN 554550341

Phone: 6126248199

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.