Avery Grace Macintosh
Avery Grace Macintosh is a Physician Assistant in Mahtomedi, Minnesota. Qualified in 2025, 1 year ago. Practices with Dermatology Associates of Siouxland PC, a 3-clinician group and accepts Medicare assignment.
- Years since qualifying
- 1
- In the registry since
- 2024
Practice location Address checks out
1040 Summit AveMahtomedi, MN 55115-1544
Phone: (651) 815-3171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1609633510 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | March 6, 2024 |
| Last updated in NPPES | March 6, 2024 |
| Certification date | March 6, 2024 |
| Mailing address | 1040 Summit Ave, Mahtomedi, MN 55115-1544 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2025 (1 years in practice) |
| Group practice | Dermatology Associates Of Siouxland Pc — 3 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Mahtomedi
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Alexander Michael Voytovich
301 Dunbar Way, Mahtomedi, MN 55115-2817 · (651) 245-6223