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

Jacob Bottelberghe

Individual provider Physician Assistant · NPI 1346894748

Jacob Bottelberghe is a Physician Assistant in Marshall, Minnesota. Qualified in 2019, 7 years ago. Practices with Avera Marshall, a 100-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019

Practice location Address checks out

300 S Bruce St
Marshall, MN 56258-1934
Phone: (507) 537-9165
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1346894748
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 25, 2019
Last updated in NPPESJuly 25, 2019
Mailing address1107 300th St, Minneota, MN 56264-1103

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Avera Marshall — 100 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Marshall