MEDICARE: MARGARET EVELYN KONTNEY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	085009314	IL
2	363A00000X	Physician Assistant	15662	MN

General Provider Information

NPI Number	:	1669171138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET EVELYN KONTNEY PA-C

Provider Business Mailing Address
First Line	:	1700 UNIVERSITY AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-3727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1747 BEAM AVE STE 100
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-1128
Country	:	US
Telephone Number	:	651-221-9051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2023
Last Update Date	:	04/21/2026

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