Individual provider Active NPI

Jason B Kimmel, PAC

  • Physician Assistant
  • Bloomington, MN
National Provider Identifier
1033176219
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9569 Issued in MN
Practice address
600 West 98TH Street
Bloomington, MN 55420-4773
Phone
(952) 881-2651
Fax
(952) 885-6065
NPI assigned
Apr 29, 2006
Reactivated
Oct 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9569 MN Primary

Addresses

Primary practice location

600 West 98TH Street
Bloomington, MN 55420-4773

Mailing address

600 West 98TH Street
Bloomington, MN 55420-4773
Phone (952) 881-2651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040515000355 MN Practitioner - Physician Assistant 6709876329 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone (612) 626-5775

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

303 E Nicollet Blvd
Suite 260
Burnsville, MN 55337-4592
Phone (952) 460-4000

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 881-2651

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6545 France Ave S
Suite 150
Edina, MN 55435-2180
Phone (952) 848-5600

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince May 20, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Oct 26, 2009 Accepting new patients
Fairview Clinics CurrentSince Oct 26, 2009 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2019 Accepting new patients
Fairview Health Services CurrentSince May 20, 2017 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 586
Edina, MN 55435
Phone (952) 915-8770

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

3305 Central Park Village Dr
#200
Saint Paul, MN 55121

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: jkimmel8853@fairview.direct-ci.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1033176219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WEST 98TH STREET",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204773",
            "telephone_number": "952-881-2651",
            "fax_number": "952-885-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WEST 98TH STREET",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204773",
            "telephone_number": "952-881-2651",
            "fax_number": "952-885-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "JASON",
        "middle_name": "B",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-29",
        "last_updated": "2012-04-05",
        "deactivation_date": "2011-09-12",
        "reactivation_date": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.