Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carmen Jean Jacobson, PA-C

Individual provider Medical Physician Assistant · NPI 1063510550

Carmen Jean Jacobson, PA-C is a Physician Assistant in Saint Paul, Minnesota. Qualified in 2003, 23 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
23
Licensed in
MN
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2550 University Ave W Ste 110N
Saint Paul, MN 55114-1052
Phone: (651) 602-5311
Fax: (651) 222-6786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 9775 (MN)

Record details

NPI number1063510550
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 20, 2006
Last updated in NPPESAugust 22, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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