Jon Juneau
Individual provider Active NPI Urology Physician · Mora, MN
NPI 1013370063 · NPPES record last updated Nov 5, 2024
Key facts
- NPI
- 1013370063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 76596 (MN)
- Practice address
- 301 Highway 65 S
Mora, MN 55051-1899 - Phone
- (320) 225-3317
- NPI assigned
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Urology
- Education
- Louisiana State University School of Medicine in New Orleans, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Welia Health
Practice addresses (Care Compare)
301 Hwy 65 S
Mora, MN 55051-1899
Phone (320) 679-1212
Hospital & facility affiliations
- Welia Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240621003023 | MN | Practitioner - Urology | 4587957642 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mille Lacs Health System | Current |
Accepting new patients | |
| Mille Lacs Health System | Current | Accepting new patients | |
| Mille Lacs Health System | Current | Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| Welia Health | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| Welia Health | Current |
Accepting new patients |
Locations
27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599
301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317
200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750
Interoperability endpoints
- jjuneau663915@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 76596 | MN | Yes |
Addresses
Primary practice location
301 Highway 65 S
Mora, MN 55051-1899
Mailing address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000
Other providers in Mora, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.