MEGAN LAUREN MAHONEY (PA) – Physician Assistant, NPI 1366274383

MEGAN LAUREN MAHONEY (PA) is a healthcare provider. based in Maplewood, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 15221 (MN). The NPI Number for MEGAN LAUREN MAHONEY (PA) is 1366274383

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MEGAN LAUREN MAHONEY (PA)
NPI
1366274383
Phone
(612) 444-3247
Address
2480 WHITE BEAR AVE N STE 104
Enumeration Date
19 August 2024
Last Update Date
28 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6124443247
Graduation Year
2024 (2 years ago)
PAC ID
5799202560
Group Practice PAC ID
1456575695
Professional Enrollment ID
I20250506000132
Address ID
MN554497439BL4181XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for MEGAN LAUREN MAHONEY (PA)

  • 2480 WHITE BEAR AVE N STE 104

    MAPLEWOOD, MN 551094568

    Phone: (612) 444-3247

    Fax: (612) 888-9247

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-05-06

PECOS data refreshed: 2026-05-27

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
I20250506000132IPhysician 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 55109)

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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: 1456575695View full group profile
NameSpecialtyState
Physician AssistantMN
Physician AssistantMN
-MN
Physician AssistantMN
Physician AssistantMN

Reviews

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Frequently asked questions

What federal number belongs to MEGAN LAUREN MAHONEY (PA)?
The federal identifier for MEGAN LAUREN MAHONEY (PA) is NPI 1366274383.
Is MEGAN LAUREN MAHONEY (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MEGAN LAUREN MAHONEY (PA) work in?
You can think of MEGAN LAUREN MAHONEY (PA) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MEGAN LAUREN MAHONEY (PA)'s primary listing?
We display Maplewood, Minnesota because that is what the record indicates for MEGAN LAUREN MAHONEY (PA).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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