Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jacqueline Faye Roff, PA-C

Individual provider Physician Assistant · NPI 1629480850

Mrs. Jacqueline Faye Roff, PA-C is a Physician Assistant in Edina, Minnesota. Qualified in 2020, 6 years ago. Practices with Intermed Consultants Dialysis PLLC, an 11-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2014
Specialties on file
2
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

6363 France Ave S Ste 400
Edina, MN 55435-2130
Phone: (952) 920-2070
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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 13705 (MN)
Athletic Trainer Taxonomy 2255A2300X · Licence 2315 (MN)

Record details

NPI number1629480850
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 22, 2014
Last updated in NPPESMay 21, 2021
Certification dateMay 21, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Intermed Consultants Dialysis Pllc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Edina