Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Chajli Chen Thao, PA-C

Individual provider Physician Assistant · NPI 1396530119

Chajli Chen Thao, PA-C is a Physician Assistant in Fridley, Minnesota. Qualified in 2025, 1 year ago. Practices with Healtheast Medical Research Institute, a 678-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
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

6401 University Ave NE
Fridley, MN 55432-4341
Phone: (763) 586-5844
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1396530119
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 11, 2025
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Healtheast Medical Research Institute — 678 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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