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

Individual provider Physician Assistant · NPI 1003323502

Jordan Thaddeus Mahieu, PA-C is a Physician Assistant in Saint Paul, Minnesota. Qualified in 2017, 9 years ago. Practices with Regions Hospital, a 219-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2018
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

640 Jackson St # MS 11102F
Saint Paul, MN 55101-2502
Phone: (952) 883-5129
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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 number1003323502
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2018
Last updated in NPPESJanuary 5, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Regions Hospital — 219 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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