Active NPI
Jacob J Panka, N.D., M.S.
- Naturopath
- Hopkins, MN
National Provider Identifier
1104380880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 1099
- Practice address
- 901 1St St N Ste 901a
Hopkins, MN 55343-7526 - Phone
- (612) 568-8382
- NPI assigned
- Jan 26, 2019
- Last updated
- Apr 10, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1099 | MN | Primary |
Addresses
Primary practice location
901 1St St N Ste 901a
Hopkins, MN 55343-7526
Mailing address
901 1St St N Ste 901a
Hopkins, MN 55343-7526
Phone (612) 568-8382
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6032-170 | Other | WI | THE STATE OF WISCONSIN NATUROPATHIC MEDICINE EXAMINING BOARD |
| 1099 | Other | MN | MINNESOTA BOARD OF MEDICAL PRACTICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1099 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1104380880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 1ST ST N STE 901A",
"city": "HOPKINS",
"state": "MN",
"postal_code": "553437526",
"telephone_number": "612-568-8382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 1ST ST N STE 901A",
"city": "HOPKINS",
"state": "MN",
"postal_code": "553437526",
"telephone_number": "612-568-8382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANKA",
"first_name": "JACOB",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "N.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-26",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "MN",
"license": "1099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE STATE OF WISCONSIN NATUROPATHIC MEDICINE EXAMINING BOARD",
"identifier": "6032-170",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF MEDICAL PRACTICE",
"identifier": "1099",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hopkins, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.