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

Todd Jeramie Holter, PAC

Individual provider Surgical Physician Assistant · NPI 1396742896

Todd Jeramie Holter, PAC is a Physician Assistant in Woodbury, Minnesota. Qualified in 2003, 23 years ago. Practices with Tria Orthopaedic Center LLC, a 506-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
23
Licensed in
MN, WI
In the registry since
2005
Specialties on file
3
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

155 Radio Dr
Woodbury, MN 55125-2619
Phone: (952) 831-8742
Fax: (952) 977-3459
Show map & directions

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

Additional practice locations (1)

  • 5803 Neal Ave N, Oak Park Heights, MN 55082-2177 — (651) 439-8807

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9820 (MN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 1684 (WI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 9820 (MN)

Record details

NPI number1396742896
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 30, 2005
Last updated in NPPESJune 30, 2023
Certification dateJune 30, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Tria Orthopaedic Center Llc — 506 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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