Jacqueline A St. John, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10479 Issued in MN

Practice address

3580 Arcade St
Vadnais Heights, MN 55127-7135

Phone

(651) 968-5770

Fax

(651) 968-5775

NPI assigned

Aug 11, 2008

Last updated

Aug 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelinest.john@sol.allscriptsdirect.net

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.

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group
• Summit Orthopedics LTD

  • Orthopaedic Surgery Physician
  • Eden Prairie, MN
  • NPI 1417639626
  NPD
• Summit Orthopedics LTD

  dba Eagan Surgery Center

  • Clinic/Center
  • Woodbury, MN
  • NPI 1558870196
  NPD
• Summit Orthopedics, LTD.

  dba Minnesota Occupational Health

  • Occupational Medicine Clinic/Center
  • Saint Paul, MN
  • NPI 1275684128
  NPD
• Ilbnc, P.a.

  dba Institute for Low Back & Neck Care

  • Orthopaedic Surgery of the Spine Physician
  • Bloomington, MN
  • NPI 1023001815
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Healtheast Woodwinds Hospital

  dba Fairview Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Care Compare affiliation

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1811143878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "651-968-5770",
            "fax_number": "651-968-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10479",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "10479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Christine Smith, MA, BCBA
• Katelyn Jean Smith
• Mary O'Shaughnessy Smith, OTR/L
• Daniel Allen Sonday, MS, ATC, OTC
• Tracy Marie St. Dennis, DDS
• Andrea Maggie Stankiewicz, DNP, APRN, PMHNP-BC
• Anthony J Sterk, PA-C
• Haley Stewart
• Heather Dawn Stirling, LICSW
• Elizabeth Stolt, LPCC, LADC

• Surgical Physician Assistant in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Surgical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.