Individual provider Active NPI

Jessica Anne Ulrich, MD

  • Pediatric Gastroenterology Physician
  • Minneapolis, MN
National Provider Identifier
1114419314
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
66120 Issued in MN
Practice address
3001 Broadway St NE Ste 120
Minneapolis, MN 55413-2196
Phone
(612) 871-1145
Fax
(612) 870-5491
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29596 MN
Pediatric Gastroenterology Physician 2080P0206X 66120 MN Primary

Addresses

Primary practice location

3001 Broadway St NE Ste 120
Minneapolis, MN 55413-2196

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808003728 MN Practitioner - Pediatric Medicine 2769739739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

3001 Broadway St NE
Suite 120
Minneapolis, MN 55413-2196
Phone (612) 871-1145

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mngi Digestive Health, P.a. CurrentSince Sep 3, 2024 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic CurrentSince Jul 25, 2019 Accepting new patients
Mayo Clinic CurrentSince Jul 25, 2019 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

3001 Broadway St NE
Ste 120
Minneapolis, MN 55413

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: jessica.ulrichmd.p1@direct.mngastro.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1114419314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BROADWAY ST NE STE 120",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132196",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "29596",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MN",
            "license": "66120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.