Active NPI
Jillian Johannes, PA-C
- Physician Assistant
- Apple Valley, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11670
- Practice address
- 14655 Galaxie Ave
Apple Valley, MN 55124-8602 - Phone
- (651) 241-3779
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 11670 | MN | |
| Physician Assistant | 363A00000X | 11670 | MN | Primary |
Addresses
Primary practice location
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000
Other practice location 1
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456
Other practice location 2
927 Churchill St W
Stillwater, MN 55082-6605
Phone (651) 439-5330
Other practice location 3
407 E 3rd St
Duluth, MN 55805-1950
Phone (218) 786-4000
Other practice location 4
405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jjohannes630157@excellian.direct.allina.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779
440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225
Hospital & facility affiliations
- Accentcare Fairview Home Health - West, LLC
- Allina United Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11670 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Marys Medical Center | Current | Accepting new patients | |
| St. Mary'S Medical Center | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357
402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141
Interoperability endpoints
- jjohannes630157@excellian.direct.allina.com
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Annandale, MN
- NPI 1457657249
-
- General Acute Care Hospital
- Duluth, MN
- NPI 1457393035
-
- Family Medicine Physician
- Richfield, MN
- NPI 1306142054
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
- Clinic/Center
- Duluth, MN
- NPI 1821835851
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Saint Paul, MN
- NPI 1477169233
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1457319485
-
- General Acute Care Hospital
- Hastings, MN
- NPI 1508457045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1083023733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14655 GALAXIE AVE",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551248602",
"telephone_number": "651-241-3779"
}
],
"practiceLocations": [
{
"address_1": "640 Jackson St",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551012502",
"country_code": "US",
"telephone_number": "651-254-3456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "927 Churchill St W",
"address_purpose": "LOCATION",
"city": "Stillwater",
"state": "MN",
"postal_code": "550826605",
"country_code": "US",
"telephone_number": "651-439-5330",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "407 E 3rd St",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "MN",
"postal_code": "558051950",
"country_code": "US",
"telephone_number": "218-786-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 Stageline Rd",
"address_purpose": "LOCATION",
"city": "Hudson",
"state": "WI",
"postal_code": "540167848",
"country_code": "US",
"telephone_number": "715-531-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHANNES",
"first_name": "JILLIAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MN",
"license": "11670",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "11670",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jjohannes630157@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "14655 Galaxie Ave",
"city": "Apple Valley",
"state": "MN",
"country_code": "US",
"postal_code": "551248602",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.