NPIMap

Individual provider Active NPI

Jerrod Tyler Heermans, M.D.

  • Urology Physician
  • Duluth, MN
National Provider Identifier
1063866796
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
79356 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Apr 19, 2016
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MED-PHYS-LIC-103596 MT
Urology Physician 208800000X DR.0066966 CO
Urology Physician 208800000X 79356 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 1

3528 30th Ave S
Fargo, ND 58103-6239
Phone (972) 207-0889

Other practice location 2

1906 Blake Ave
Glenwood Springs, CO 81601-4259
Phone (970) 928-0808

Other practice location 3

350 Heritage Way Ste 2300
Kalispell, MT 59901-3167
Phone (406) 890-7432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, MN, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211202002689 MT Practitioner - Urology 6709171069
I20250410003125 MN Practitioner - Urology 6709171069 Reassigns benefits to 3 organizations
I20250428000862 WI Practitioner - Urology 6709171069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of North Dakota School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 392-8281

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7714NEMDGeneral Practice Dentistry
DR.0066966COMDUrology Physician
79356MNMDUrology Physician
MED-PHYS-LIC-103596MTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior Current Accepting new patients
Essentia Health Moose Lake CurrentSince May 5, 2025 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 5, 2025 Accepting new patients
The Duluth Clinic, LTD CurrentSince May 5, 2025 Accepting new patients
Essentia Health Moose Lake CurrentSince May 5, 2025 Accepting new patients
St. Mary's Hospital of Superior CurrentSince May 5, 2025 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Essentia Health Virginia LLC Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 10

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1063866796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3528 30th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581036239",
            "country_code": "US",
            "telephone_number": "972-207-0889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1906 Blake Ave",
            "address_purpose": "LOCATION",
            "city": "Glenwood Springs",
            "state": "CO",
            "postal_code": "816014259",
            "country_code": "US",
            "telephone_number": "970-928-0808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Heritage Way Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-890-7432",
            "fax_number": "406-890-7402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERMANS",
        "first_name": "JERROD",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "MED-PHYS-LIC-103596",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "DR.0066966",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "79356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.