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

Mimi Harzan, MSPA, PA-C

Individual provider Medical Physician Assistant · NPI 1477175446

Mimi Harzan, MSPA, PA-C is a Physician Assistant in Bend, Oregon. Qualified in 2021, 5 years ago. Practices with St Charles Health System Inc, a 383-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone: (541) 706-6915
Fax: (541) 706-6733
Show map & directions

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

Additional practice locations (2)

  • 305 W Jackson St Ste 206, Carbondale, IL 62901-1474 — (618) 457-3006
  • 220 S Park Ave Fl 3, Herrin, IL 62948-3602 — (618) 942-2002

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085008538 (IL)
Medical Physician Assistant Taxonomy 363AM0700X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477175446
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSPA , PA-C
Sole proprietorYes
NPI enumeratedMay 13, 2020
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Charles Health System Inc — 383 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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