Individual provider Active NPI

Jasmin Nicole Lindberg, PA-C

  • Physician Assistant
  • Otsego, MN
National Provider Identifier
1184341984
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14266 Issued in MN
Practice address
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone
(763) 746-9492
NPI assigned
Oct 21, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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 14266 MN Primary

Addresses

Primary practice location

9245 Quantrelle Ave NE
Otsego, MN 55330-0168

Mailing address

9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone (763) 746-9492

Other names 1

  • Jasmin Nicole Bretoi Former name

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
I20230220001340 MN Practitioner - Physician Assistant 5991177099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 968-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14266MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1184341984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168",
            "telephone_number": "763-746-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168",
            "telephone_number": "763-746-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBERG",
        "first_name": "JASMIN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMIN",
            "last_name": "BRETOI",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Otsego, MN

Sources for this page

Verify at the official NPI Registry.