Jack Leroy Foster III, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

15708 Issued in MN

Practice address

1000 E 1St St Ste 404
Duluth, MN 55805-2265

Phone

(218) 722-5513

NPI assigned

Feb 27, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Associates of Duluth PAGroup PAC ID 1951294065, 37 clinicians

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Orthopedic Associates of Duluth, P.a.

  • Specialist
  • Duluth, MN
  • NPI 1225033715

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment Care Compare group
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1881450740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052265",
            "telephone_number": "218-722-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052265",
            "telephone_number": "218-722-5513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Progress Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Virginia",
            "state": "MN",
            "postal_code": "557923068",
            "country_code": "US",
            "telephone_number": "218-735-6290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "JACK",
        "middle_name": "LEROY",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-27",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "15708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ann Fosle, OT
• Ariel Foss
• Kaitlin Emma Foss, MSW, LICSW
• Larissa Isabelle Fossum, BEHAVIORAL TECH
• Isaiah Foster
• Taylor Fournier, PA-C
• Lora Kay Foust, OTR/L, SCLV
• Sara Elizabeth Fouts, OTR-L
• Tara Fouts
• Dean Michael Fox, MD

• Surgical Physician Assistant in Duluth, MN
• Providers in Duluth, 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 May 8, 2026; 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.