Individual provider Active NPI

Jessica F Jandric, PAC

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1053359000
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
874 Issued in MN
Practice address
1026 W 7TH Street
St Paul, MN 55102-3007
Phone
(651) 241-1000
NPI assigned
Jun 3, 2006
Last updated
Mar 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 874 MN Primary

Addresses

Primary practice location

1026 W 7TH Street
St Paul, MN 55102-3007

Mailing address

1026 W 7TH Street
St Paul, MN 55102-3007
Phone (651) 241-1000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060724000308 MN Practitioner - Physician Assistant 7618980376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

1700 University Ave W
Saint Paul, MN 55104-3727

1875 Woodwinds Dr
Woodbury, MN 55125-2298
Phone (651) 232-6800

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

980 Rice St
Saint Paul, MN 55117-4949
Phone (651) 326-9020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
874MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Nov 30, 2014 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Nov 30, 2014 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2022 Accepting new patients
Fairview Health Services CurrentSince Nov 30, 2014 Accepting new patients
Fairview Clinics CurrentSince Nov 30, 2014 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

980 Rice St
Saint Paul, MN 55117
Phone (651) 326-9020

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: jjandric328721@fairview.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1053359000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDRIC",
        "first_name": "JESSICA",
        "middle_name": "F",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.