Jeffrey Thomas Weideman, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10628 Issued in MN

Practice address

125 Saint Andrews CT Ste 200
Mankato, MN 56001-8600

Phone

(507) 550-0072

NPI assigned

Aug 10, 2009

Last updated

Oct 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffreyweideman@mklt.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029
  Medicare reassignment Care Compare group
• Minnesota Dermatology Associates PLLC

  • Clinic/Center
  • Mankato, MN
  • NPI 1790616068
  NPD
• Mankato Clinic Express, LLC

  • Physician Assistant
  • Mankato, MN
  • NPI 1265626964
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793059200000",
    "number": "1013149079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SAINT ANDREWS CT STE 200",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018600",
            "telephone_number": "507-550-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAINT ANDREWS CT STE 200",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018600",
            "telephone_number": "507-550-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDEMAN",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Katherine Weber, DDS
• Luke Alan Weber, D.C.
• Elisabeth Wech, DPT
• Waclaw Wedzina, MD
• Colin W. Weerts, D.O.
• Rachel Weigel
• Dylan Douglas Weihe
• Emily Beatrice Weimer, D.O.
• Kenneth C Weimer, MD
• Molly Jean Weinberger

• Medical Physician Assistant in Mankato, MN
• Providers in Mankato, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.