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

Miranda Mathison

Individual provider Physician Assistant · NPI 1598168395

Miranda Mathison is a Physician Assistant in Fargo, North Dakota. Qualified in 2014, 12 years ago. Practices with Innovis Health LLC, a 573-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
12
Licensed in
ND
In the registry since
2014
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Practice location Address checks out

2301 25th St S
Fargo, ND 58103-6104
Phone: (701) 237-9712
Fax: (701) 237-0922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PAC0578 (ND)

Record details

NPI number1598168395
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 7, 2014
Last updated in NPPESFebruary 21, 2022
Certification dateFebruary 21, 2022
Mailing addressPo Box 5074, Sioux Falls, SD 57117-5074

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 Innovis Health Llc — 573 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fargo