Individual provider Active NPI

Jona Bakke, PA-C

  • Medical Physician Assistant
  • Edina, MN
National Provider Identifier
1376265504
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
14200 Issued in MN
Practice address
7600 France Ave S Ste 4100
Edina, MN 55435-6027
Phone
(952) 831-1551
Fax
(952) 831-0725
NPI assigned
Sep 14, 2022
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 14200 MN Primary
Family Medicine Physician 207Q00000X 14200 MN

Addresses

Primary practice location

7600 France Ave S Ste 4100
Edina, MN 55435-6027

Mailing address

7600 France Ave S Ste 4100
Edina, MN 55435-6027
Phone (952) 831-1551

Other identifiers 1

IdentifierTypeStateIssuer
14200OtherMNSTATE LICENSE

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
I20221003000389 MN Practitioner - Physician Assistant 1951787753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
France Avenue Family Physicians, P.a.Group PAC ID 9234038837, 9 clinicians

Practice addresses (Care Compare)

7600 France Ave S
Suite 4100
Edina, MN 55435-6027
Phone (952) 831-1551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14200MNMDNurse Practitioner

Organizations & group practices 1

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1376265504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 FRANCE AVE S STE 4100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554356027",
            "telephone_number": "952-831-1551",
            "fax_number": "952-831-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 FRANCE AVE S STE 4100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554356027",
            "telephone_number": "952-831-1551",
            "fax_number": "952-831-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKE",
        "first_name": "JONA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "14200",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "14200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "14200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.