Individual provider Active NPI

Jaci Kay Ziyue Tourtellott, PA-C

  • Physician Assistant
  • Buffalo, MN
National Provider Identifier
1902618838
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15235 Issued in MN
Practice address
1700 Highway 25 N
Buffalo, MN 55313-1930
Phone
(763) 682-1313
NPI assigned
Jan 27, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 15235 MN Primary

Addresses

Primary practice location

1700 Highway 25 N
Buffalo, MN 55313-1930

Mailing address

1700 Highway 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jtourtellott213584@direct.northmemorial.com
Direct Messaging Address jtourtellott213584@direct.northmemorial.com

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
I20250225003851 MN Practitioner - Physician Assistant 6406376037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stellis Health, PAGroup PAC ID 1153233796, 54 clinicians

Practice addresses (Care Compare)

1001 Hart Blvd
Suite 100
Monticello, MN 55362-8929
Phone (763) 682-1313

1700 Hwy 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stellis Health, PA CurrentSince Mar 1, 2025 Accepting new patients

Locations

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

1001 Hart Blvd
Ste 100
Monticello, MN 55362
Phone (763) 295-2921

Interoperability endpoints

  • Direct secure messaging: jtourtellott213584@direct.northmemorial.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1902618838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOURTELLOTT",
        "first_name": "JACI",
        "middle_name": "KAY ZIYUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtourtellott213584@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1700 Highway 25 N",
            "city": "Buffalo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553131930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtourtellott213584@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.