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Deactivated NPI 1346347952 Deactivated / Inactive NPI Female Practitioner

Eileen June Decorah , PA-C

Physician Assistant • Blaine, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Eileen Decorah has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 19, 2006
NPI Deactivation Date May 02, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Eileen Decorah, PA-C was a registered Physician Assistant practicing in Blaine, MN. Throughout an active medical career spanning 11 years, Eileen Decorah provided care at the practice location at 1500 109TH AVE NE until profile deactivation on 2017-05-02.

Practice Location & Contact Primary Location

Practice Address

1500 109th Ave Ne

Blaine, MN 554494670

Telephone 8153639500
Associated Practice Facility / Clinic
🏢 Grand St Paul Cvs Llc Facility NPI 1215959903

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Blaine, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
26 Specialists

Practicing in Blaine, MN (4026 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MN 926

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Jennifer Wetteland , PA-C

Physician Assistant

NPI 1396804282

Physician Assistant (Certified)

Dr. John Machado , MD

Family Medicine

NPI 1932040151

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 02, 2017

Record deactivated on May 02, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1500 109TH AVE NE, BLAINE, MN 554494670 (Tel: 8153639500)

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Updated Business Mailing Address July 08, 2007

Registered at 612 FARMER AVE, TOMAH, WI 546602237 (Tel: 6083727073)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EILEEN DECORAH, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #926 in MN)

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Initial NPI Registration & Enumeration September 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346347952
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 19, 2006
Last Update: July 08, 2007
Deactivation Date: May 02, 2017

Mailing Address

612 Farmer Ave

Tomah, WI 546602237

Phone: 6083727073

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.