MITCHELL J MIMBACH (PA) – Physician Assistant, NPI 1013528900

MITCHELL J MIMBACH (PA) is a healthcare provider. based in Rice, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 13451 (MN). The NPI Number for MITCHELL J MIMBACH (PA) is 1013528900

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
MITCHELL J MIMBACH (PA)
NPI
1013528900
Phone
(320) 493-2531
Address
1204 3RD ST SW
Enumeration Date
13 August 2020
Last Update Date
11 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
7719391879
Group Practice PAC ID
9537146550
Professional Enrollment ID
I20210201001175
Address ID
MN564411645Cr320XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

4,048 PHYSICIAN ASSISTANT in MN

Provider Addresses for MITCHELL J MIMBACH (PA)

  • 1204 3RD ST SW

    RICE, MN 563678846

    Phone: (320) 493-2531

    Type: Mailing

  • 320 EAST MAIN ST

    CROSBY, MN 56441

    Phone: (218) 546-7000

    Fax: (218) 546-4400

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $132.

Total Amount is formed as General ($132) + Research ($0) + Ownership ($0) = $132.

Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($79).

Total Amount

$132

General + Research + Ownership

Payments

2

Total payment records

General Amount

$132

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-02-01

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210201001175IPhysician AssistantMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56367)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537146550View full group profile
NameSpecialtyState
Physician AssistantMN
Nurse PractitionerMN
-MN
Nurse PractitionerMN
Family PracticeMN
Certified Registered Nurse Anesthetist (Crna)IN
H O S P I T A L I S TMN
Nurse PractitionerMN
Family PracticeMN
P O D I A T R YFL

Reviews

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Frequently asked questions

Is MITCHELL J MIMBACH (PA) listed with a National Provider Identifier?
Yes — MITCHELL J MIMBACH (PA) has NPI 1013528900 on file in the registry.
Would MITCHELL J MIMBACH (PA) appear as active to a payer?
You can treat MITCHELL J MIMBACH (PA) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe MITCHELL J MIMBACH (PA)'s focus?
For MITCHELL J MIMBACH (PA), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MITCHELL J MIMBACH (PA) located near Rice?
MITCHELL J MIMBACH (PA) currently maps to Rice, Minnesota in this extract.
When was this NPI issued?
Enumeration for MITCHELL J MIMBACH (PA) is noted as August 13, 2020 where the registry provides it.

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