NPIMap

Individual provider Active NPI

Bobbi J Jensen, PA

  • Physician Assistant
  • Winona, MN
National Provider Identifier
1316926199
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10045 Issued in MN
Practice address
855 Mankato Ave
Winona, MN 55987-4868
Phone
(507) 454-3650
NPI assigned
Jan 11, 2006
Last updated
Sep 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 10045 MN Primary

Addresses

Primary practice location

855 Mankato Ave
Winona, MN 55987-4868

Mailing address

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650

Other identifiers 3

IdentifierTypeStateIssuer
P00274616OtherMNMEDICARE RAILROAD
ENROLLEDMedicaidMN
271982700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051031000977 MN Practitioner - Physician Assistant 5991780348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winona Health ServicesGroup PAC ID 8527977420, shared by 7 NPIs, 160 clinicians

Practice addresses (Care Compare)

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10045MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Winona Health Services CurrentSince Sep 1, 2016 Accepting new patients
Winona Health Services CurrentSince Nov 10, 2022 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

107 W 4th St
Ste B102
Winona, MN 55987
Phone (507) 457-7620

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

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.

Hospital & facility affiliations 8

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1316926199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "BOBBI",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00274616",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271982700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.