Individual provider Active NPI

Jennifer Ruth Larson, PA-C

  • Physician Assistant
  • Shakopee, MN
National Provider Identifier
1285684555
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9789 Issued in MN
Practice address
1515 Saint Francis Ave
Suite 150
Shakopee, MN 55379-3387
Phone
(952) 403-3399
Fax
(952) 403-3390
NPI assigned
May 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 9789 MN Primary

Addresses

Primary practice location

1515 Saint Francis Ave
Suite 150
Shakopee, MN 55379-3387

Mailing address

21195 Radisson Rd
Shorewood, MN 55331-9189
Phone (952) 470-3976

Other identifiers 1

IdentifierTypeStateIssuer
216702600MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100306000100 MN Practitioner - Physician Assistant 6709921349 Reassigns benefits to 1 organization
I20120504000363 WI Practitioner - Physician Assistant 6709921349 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

2310 Craig Rd
Eau Claire, WI 54701-6128
Phone (715) 858-8100

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

5601 96TH Ave N
Brooklyn Park, MN 55443-4505
Phone (763) 786-9543

9630 Grove Cir N
Suite 200
Maple Grove, MN 55369-3492
Phone (763) 520-7870

965 Prairie Ctr Dr
Eden Prairie, MN 55344-3671

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Merit-based Incentive Payment System (MIPS)

Final score
93.47 of 100Reported as group
Quality
79.03
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9789MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Mar 19, 2012 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Infinite Health Collaborative, PA CurrentSince Apr 3, 2022 Accepting new patients
Memorial Hospital Inc CurrentSince Mar 19, 2012 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Apr 3, 2022 Accepting new patients
Adefris & Toppin Women's Specialists,MDPC Past Accepting new patients
Orthopedic Surgical Consultants, P.a. Physician Assistant Past Accepting new patients

Locations

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

1515 Saint Francis Ave
Ste 150
Shakopee, MN 55379
Phone (952) 403-1038

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: jennifer.larson@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 10

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285684555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21195 RADISSON RD",
            "city": "SHOREWOOD",
            "state": "MN",
            "postal_code": "553319189",
            "telephone_number": "952-470-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SAINT FRANCIS AVE",
            "address_2": "SUITE 150",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793387",
            "telephone_number": "952-403-3399",
            "fax_number": "952-403-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNIFER",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216702600",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.