Individual provider Active NPI

Jacob Martin Naslund, PA-C

  • Physician Assistant
  • Maplewood, MN
National Provider Identifier
1104570399
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14360 Issued in MN
Practice address
1600 Saint Johns Blvd Ste 200
Maplewood, MN 55109-1190
Phone
(651) 232-7180
NPI assigned
Feb 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 14360 MN Primary

Addresses

Primary practice location

1600 Saint Johns Blvd Ste 200
Maplewood, MN 55109-1190

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727

Other practice location 1

407 E 3rd St
Duluth, MN 55805-1950
Phone (218) 786-4000

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
I20230314002149 MN Practitioner - Physician Assistant 5395119390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

1600 Saint Johns Blvd
Suite 200
Maplewood, MN 55109-1190
Phone (651) 326-2328

1700 University Ave W
Saint Paul, MN 55104-3727

1875 Woodwinds Dr
Suite 240
Woodbury, MN 55125-2517
Phone (651) 326-2328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14360MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Mar 27, 2023 Accepting new patients
The Duluth Clinic LTD CurrentSince Mar 27, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 15, 2024 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 15, 2024 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

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

1600 Saint Johns Blvd
Ste 200
Saint Paul, MN 55109
Phone (651) 326-4327

1875 Woodwinds Dr
Ste 110
Woodbury, MN 55125
Phone (651) 686-6400

Interoperability endpoints

  • Direct secure messaging: jnaslund1432087@fairview.direct-ci.com

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1104570399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT JOHNS BLVD STE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091190",
            "telephone_number": "651-232-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051950",
            "country_code": "US",
            "telephone_number": "218-786-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASLUND",
        "first_name": "JACOB",
        "middle_name": "MARTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.