Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Simon Henry Lueth, PAC

Individual provider Physician Assistant · NPI 1215357108

Simon Henry Lueth, PAC is a Physician Assistant in Oak Park Heights, Minnesota. Qualified in 2014, 12 years ago. Practices with Fairview Express Care, a 1,964-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
12
Licensed in
MN, WI
In the registry since
2014
Specialties on file
3
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone: (651) 439-8807
Fax: (651) 439-0232
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 640 Jackson St, Saint Paul, MN 55101-2502 — (651) 495-6600

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11596 (MN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 11596 (MN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 3312-23 (WI)

Record details

NPI number1215357108
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedApril 18, 2014
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026

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 Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients16
Services billed 17 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Fairview Express Care

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1964 clinicians in the practice; 12 are shown here.

Other providers in Oak Park Heights