Individual provider Active NPI

Mitchell Forrest Jaeger, PA-C

  • Physician Assistant
  • Marshfield, WI
National Provider Identifier
1750173035
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone
(715) 387-5511
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 Primary

Addresses

Primary practice location

1000 N Oak Ave
Marshfield, WI 54449-5703

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

4300 Market Pte Dr St 100
Bloomington, MN 55435-5435
Phone (952) 767-4574

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Direct

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
I20250812002112 MN Practitioner - Physician Assistant 5294233987 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association CurrentSince Sep 15, 2025 Accepting new patients
Emergency Physicians Professional Association CurrentSince Sep 15, 2025 Accepting new patients

Locations

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

Interoperability endpoints

  • Direct secure messaging: mjaeger886629@direct.centracare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1750173035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Market Pte Dr St 100",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554355435",
            "country_code": "US",
            "telephone_number": "952-767-4574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "MITCHELL",
        "middle_name": "FORREST",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.