NPIMap

Individual provider Active NPI

Jenna Michele Clements, PA

  • Physician Assistant
  • Coon Rapids, MN
National Provider Identifier
1851924302
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13430 Issued in MN
Practice address
11850 Blackfoot St NW Ste 450
Coon Rapids, MN 55433-2773
Phone
(763) 780-9155
Fax
(763) 236-1066
NPI assigned
Feb 12, 2020
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 13430 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

11850 Blackfoot St NW Ste 450
Coon Rapids, MN 55433-2773

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

507 N 17th St
Milwaukee, WI 53233
Phone (414) 288-5688

Other names 1

  • Jenna Michele Borgstrom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200923000289 MN Practitioner - Physician Assistant 2264851369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

11850 Blackfoot St NW
Coon Rapids, MN 55433-2773

2925 Chicago Ave
Minneapolis, MN 55407-1321

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

6001 96TH LN N
Suite 100
Brooklyn Park, MN 55445-4602
Phone (952) 946-9777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13430MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Sep 28, 2020 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Sep 28, 2020 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

6001 96th Ln N
Ste 100
Brooklyn Park, MN 55445

11850 Blackfoot St NW
Ste 450
Coon Rapids, MN 55433
Phone (763) 236-0800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

8100 W 78th St
Ste 230
Minneapolis, MN 55439
Phone (952) 836-4281

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

Interoperability endpoints

  • Direct secure messaging: jborgstrom458396@excellian.direct.allina.com

Organizations & group practices 6

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.

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1851924302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000",
            "fax_number": "612-262-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 450",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332773",
            "telephone_number": "763-780-9155",
            "fax_number": "763-236-1066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 N 17th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53233",
            "country_code": "US",
            "telephone_number": "414-288-5688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "JENNA",
        "middle_name": "MICHELE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13430",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "BORGSTROM",
            "middle_name": "MICHELE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.