Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Austin James Heneman, PA-C

Individual provider Physician Assistant · NPI 1093191777

Austin James Heneman, PA-C is a Physician Assistant in Roseville, Minnesota. Qualified in 2015, 11 years ago. Practices with Tareen Dermatology PA, a 44-clinician group and works from 2 locations. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306
Phone: (651) 633-6883
Fax: (651) 331-3459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9766 Fallon Ave Ne Ste 102, Monticello, MN 55362-4589 — (651) 633-6883

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11882 (MN)

Record details

NPI number1093191777
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 5, 2015
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Tareen Dermatology Pa — 44 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

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