Tasheena Broadnax
Physician Assistant in Brooklyn Park, MN. Individual provider (NPI-1).
NPI number1033997242
StatusActive
Last updated in NPPESJun 23, 2025
Details
- NPI
- 1033997242
- Entity type
- Individual (NPI-1)
- Name
- Tasheena Broadnax
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2023
- Certification date
- Jun 23, 2025
- Last updated
- Jun 23, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 15206 | MN | Yes |
Practice location
10000 Zane Ave NBrooklyn Park, MN 55443-1400
Phone 763-528-6999
Mailing address
10000 Zane Ave NBrooklyn Park, MN 55443-1400
Phone 763-528-6999
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Physician Assistant providers in Brooklyn Park · All 1,366 providers in Brooklyn Park
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