Jacob Daniels, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4365 Pheasant Ridge Dr NE Ste 106
Blaine, MN 55449-4544

Phone

(888) 938-3838

Fax

(888) 919-1083

NPI assigned

Mar 9, 2022

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

University of Iowa, RJ & L Carver College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Institutes LLCGroup PAC ID 4880928761, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jdaniels@advent.emadirect.md

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.

• Ear Institutes, LLC

  • Otolaryngology Physician
  • Blaine, MN
  • NPI 1881168441
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1265189161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 PHEASANT RIDGE DR NE STE 106",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494544",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Dahlgren, D.D.S.
• Tyler G Dahlgren, PHARMD
• Bruce George Dahlman, P.T.
• Eliza S Dahly, PA-C
• Serenity Anne Daniel
• Davinci Academy of Arts and Science
• Batool Dawood, PHARM D
• Malia J Dean
• Seth Kyle Dean
• Joshua Dehn

• Physician Assistant in Blaine, MN
• Providers in Blaine, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.