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

Jonathon David Jaqua, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396062923

Jonathon David Jaqua, DO is an Obstetrics/Gynecology in Edina, Minnesota. Qualified in 2010, 16 years ago. Practices with Premier OBGYN of Minnesota PLLC, a 89-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
16
Licensed in
MN
In the registry since
2010
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3625 W 65th St Ste 100
Edina, MN 55435
Phone: (952) 920-7001
Fax: (612) 626-0665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 57244 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396062923
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 21, 2010
Last updated in NPPESAugust 22, 2014
Mailing address3625 W. 65th Street, Suite 100, Edina, MN 55435

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Premier Obgyn Of Minnesota Pllc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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