Individual provider Active NPI

Jordan Nicole Scheunemann, PA-C

  • Physician Assistant
  • Shoreview, MN
National Provider Identifier
1407654064
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15268 Issued in MN
Practice address
404 Highway 96 W
Shoreview, MN 55126-1900
Phone
(651) 483-8283
Fax
(651) 483-8299
NPI assigned
Mar 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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 15268 MN Primary

Addresses

Primary practice location

404 Highway 96 W
Shoreview, MN 55126-1900

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

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
I20250429002739 MN Practitioner - Physician Assistant 5193241420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

234 Wentworth Ave E
West St Paul, MN 55118-3525
Phone (651) 788-4444

2601 Centennial Dr
Suite 100
North St Paul, MN 55109-3087
Phone (651) 788-4444

3550 Labore Rd
Suite 7
Vadnais Heights, MN 55110-5113
Phone (651) 788-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15268MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. CurrentSince May 26, 2025 Accepting new patients
East Metro Family Practice, P.a. Past Accepting new patients
Family Healthservices Minnesota, P.a. Past Accepting new patients

Locations

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

404 Highway 96 W
Shoreview, MN 55126
Phone (651) 482-8080

Interoperability endpoints

  • Direct secure messaging: jordan.scheunemann@entira.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1407654064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HIGHWAY 96 W",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261900",
            "telephone_number": "651-483-8283",
            "fax_number": "651-483-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEUNEMANN",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

Verify at the official NPI Registry.