NPIMap

Individual provider Active NPI

Amanda Jurvis, D.O.

  • Emergency Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1083063069
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
65394 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(651) 241-8755
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101022558 MI
Emergency Medicine Physician 207P00000X 65394 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279
Phone (612) 439-1860

Other practice location 1

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

Other practice location 2

701 Park Ave
Minneapolis, MN 55415-1623
Phone (248) 898-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190719002734 MN Practitioner - Emergency Medicine 3375834849 Reassigns benefits to 5 organizations
I20230308000081 WI Practitioner - Emergency Medicine 3375834849 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Consultants PAGroup PAC ID 5496640161, 105 clinicians

Practice addresses (Care Compare)

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022558MIMDEmergency Medicine Physician
65394MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecc Addiction & Toxicology Services LLC CurrentSince Aug 28, 2022 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Feb 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Jul 22, 2019 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jul 15, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 22, 2019 Accepting new patients
Sanford Health Network North Current Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Fairview Health Services Current Accepting new patients
Lifecare Medical Center Current Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jul 15, 2019 Accepting new patients

Locations

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

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

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

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

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

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

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1083063069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279",
            "telephone_number": "612-439-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-672-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "248-898-2001",
            "fax_number": "248-898-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JURVIS",
        "first_name": "AMANDA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022558",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "65394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.