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

Individual provider Surgical Physician Assistant · NPI 1013986611

Jennifer Susan Ellis, PA-C is a Physician Assistant in Woodbury, Minnesota. Qualified in 2000, 26 years ago. Practices with Infinite Health Collaborative, PA, a 814-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
26
Licensed in
MN
In the registry since
2006
Specialties on file
2
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

4040 Radio Dr
Woodbury, MN 55129-3237
Phone: (651) 439-8807
Fax: (651) 439-0232
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9602 (MN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 9602 (MN)

Record details

NPI number1013986611
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 16, 2006
Last updated in NPPESSeptember 25, 2020
Certification dateSeptember 25, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Infinite Health Collaborative, Pa — 814 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Woodbury