Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Leah C Matheson

Individual provider Medical Physician Assistant · NPI 1619383684

Leah C Matheson is a Physician Assistant in St Paul, Minnesota. Qualified in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2014
Specialties on file
2

Practice location Address checks out

640 Jackson Street Mc 11109E
St Paul, MN 55101-2502
Phone: (651) 254-3456
Fax: (651) 254-9673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 11598 (MN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 2096 (MN)

Record details

NPI number1619383684
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 10, 2014
Last updated in NPPESOctober 26, 2015
Mailing addressPo Box 1309, 8170 33rd Ave S - Mail Stop 21110q, Minneapolis, MN 55425-4516

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in St Paul