Individual provider Active NPI

Tamra J Gilbertson, PA-C

  • Medical Physician Assistant
  • Bemidji, MN
National Provider Identifier
1730367939
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2150 Issued in MN
Practice address
1611 Anne St NW
Bemidji, MN 56601-5114
Phone
(218) 333-5000
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0664 SD
Medical Physician Assistant 363AM0700X 2150 MN Primary

Addresses

Primary practice location

1611 Anne St NW
Bemidji, MN 56601-5114

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Other practice location 1

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 751-5430

Other names 1

  • Tamra J Jacobsen Former name

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
I20141021002418 MN Practitioner - Physician Assistant 4183701592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.53 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40
Cost
95.93

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0664SDMDSpecialist
2150MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Professionals PA CurrentSince Apr 1, 2021 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Nov 11, 2024 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients

Locations

13359 Isle Dr
Ste 3
Baxter, MN 56425
Phone (218) 454-7546

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

Organizations & group practices 5

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 2

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": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1730367939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015114",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566015103",
            "country_code": "US",
            "telephone_number": "218-751-5430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "TAMRA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0664",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "2150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMRA",
            "last_name": "JACOBSEN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.