Jenna Audrey Rotty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11605 Issued in MN

Practice address

8600 Nicollet Ave S
Bloomington, MN 55420-2824

Phone

(952) 541-2800

NPI assigned

Jun 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenna Audrey Peper Former name

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

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD (past)
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1578932943
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1497169031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NICOLLET AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202824",
            "telephone_number": "952-541-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTY",
        "first_name": "JENNA",
        "middle_name": "AUDREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "PEPER",
            "middle_name": "AUDREY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Rossbach
• Amber Dawn Rossin, CNP
• Thomas J Rossini, MD
• Jenna Lynn Rothanburg
• Tyler Rother, PHARMD
• Michael Jennings Routt, DDS
• Roy Krengel DDS PA
• Royal Crown Homes
• Royalty Healthcare Staffing LLC
• Royalty Homecare Services LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.