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

Madison Thalacker, PA-S

Individual provider Physician Assistant · NPI 1639928013

Madison Thalacker, PA-S is a Physician Assistant in Minneapolis, Minnesota. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2

Practice location Address checks out

2211 Riverside Ave
Minneapolis, MN 55454-1350
Phone: (612) 330-1399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1639928013
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-S
Sole proprietorNo
NPI enumeratedMay 16, 2024
Last updated in NPPESMay 16, 2024
Certification dateMay 16, 2024
Mailing address1010 Sussex Dr, Eau Claire, WI 54703-2096

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