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

Mr. Michael Blake Jacob, PA-C

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1821502154

Mr. Michael Blake Jacob, PA-C is a Physician Assistant in Plymouth, Minnesota. Qualified in 2017, 9 years ago. Practices with Allina Health System, a 3,867-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2855 Campus Dr
Plymouth, MN 55441-2649
Phone: (763) 577-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 800 E 28th St, Minneapolis, MN 55407-3723 — (612) 863-4000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12593 (MN)
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X · Licence 12595 (MN)

Record details

NPI number1821502154
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 22, 2017
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021

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 Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare