Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Geoffrey J Theobald, PA-C

Individual provider Physician Assistant · NPI 1780642082

Mr. Geoffrey J Theobald, PA-C is a Physician Assistant in Saint Paul, Minnesota. Graduated from Sanford School of Medicine of University of South Dakota in 2003, 23 years ago. Practices with Fairview Express Care, a 1,964-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
23
Trained at
Sanford School of Medicine of University of South Dakota
Licensed in
MN
In the registry since
2006
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

1700 University Ave W
Saint Paul, MN 55104-3727
Phone: (855) 324-7843
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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 10003 (MN)

Record details

NPI number1780642082
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 3, 2006
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA
Graduated 2003 (23 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations14 on file with Medicare

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