JENNIFER THUL (PA-C) – Physician Assistant, NPI 1912716374

JENNIFER THUL (PA-C) is a healthcare provider. based in Minneapolis, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for JENNIFER THUL (PA-C) is 1912716374

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER THUL (PA-C)
NPI
1912716374
Phone
(612) 682-2008
Address
740 PORTLAND AVE STE C101
Enumeration Date
31 December 2024
Last Update Date
11 February 2025

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3202579555
Graduation Year
2024 (2 years ago)
PAC ID
4587185251
Group Practice PAC ID
7517383987
Professional Enrollment ID
I20250311000489
Address ID
MN563774637SA2380XDRXX305
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

4,032 PHYSICIAN ASSISTANT in MN

Provider Addresses for JENNIFER THUL (PA-C)

  • 740 PORTLAND AVE STE C101

    MINNEAPOLIS, MN 554153603

    Phone: (612) 682-2008

    Type: Mailing

  • 2380 Troop Drive

    Suite 202

    Sartell, MN 56377

    Phone: (320) 348-7470

    Type: Location

  • 1101 South 1st Street

    Wilmar, MN 56201

    Phone: (320) 403-9035

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250311000489IPhysician AssistantMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55415)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517383987View full group profile
NameSpecialtyState
Maxillofacial SurgeryMN
Nurse PractitionerMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

Can I verify JENNIFER THUL (PA-C) with an NPI only?
You can start verification with NPI 1912716374 for JENNIFER THUL (PA-C), then check state licensing separately.
Can I rely on JENNIFER THUL (PA-C) being an active provider?
As of the registry snapshot, JENNIFER THUL (PA-C) is marked active.
What taxonomy line describes JENNIFER THUL (PA-C)?
For research purposes, treat JENNIFER THUL (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect JENNIFER THUL (PA-C) on a map?
Expect Minneapolis, Minnesota as a primary anchor for JENNIFER THUL (PA-C) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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