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

Individual provider Physician Assistant · NPI 1356486963

Mr. Jesse L Goembel, PA-C is a Physician Assistant in Fridley, Minnesota. Qualified in 2006, 20 years ago. Practices with Centracare Clinic, a 782-clinician group and accepts Medicare assignment. Licensed in South Dakota.

Years since qualifying
20
Licensed in
SD
In the registry since
2007
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

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone: (763) 236-5000
Fax: (763) 236-3516
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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 0643 (SD)

Record details

NPI number1356486963
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 21, 2007
Last updated in NPPESNovember 10, 2020
Certification dateNovember 10, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Centracare Clinic — 782 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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