NPIMap

Individual provider Active NPI

Jennifer M Vesely, M.D.

  • Family Medicine Physician
  • St Louis Park, MN
National Provider Identifier
1124346465
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54308 Issued in MN
Practice address
6600 Excelsior Blvd
Suite 160
St Louis Park, MN 55426-4744
Phone
(952) 993-7711
Fax
(952) 993-6798
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54308 MN Primary

Addresses

Primary practice location

6600 Excelsior Blvd
Suite 160
St Louis Park, MN 55426-4744

Mailing address

6600 Excelsior Blvd
Suite 160
St Louis Park, MN 55426-4744
Phone (952) 993-7711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111101000454 MN Practitioner - Family Practice 8820261167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone (952) 993-4900

8401 Golden Valley Rd
Golden Valley, MN 55427-4486
Phone (952) 993-8300

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Care SVCS Home health agency, Minneapolis, MN, CCN 247151
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54308MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
Group Health, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Group Health, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 2011 Accepting new patients

Locations

8401 Golden Valley Rd
Ste 100
Golden Valley, MN 55427
Phone (952) 993-8300

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

6600 Excelsior Blvd
Ste 160
St Louis Park, MN 55426
Phone (952) 993-7700

Interoperability endpoints

  • Direct secure messaging: jvesely160150@direct.healthpartners.com

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.

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1124346465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD",
            "address_2": "SUITE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264744",
            "telephone_number": "952-993-7711",
            "fax_number": "952-993-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD",
            "address_2": "SUITE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264744",
            "telephone_number": "952-993-7711",
            "fax_number": "952-993-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESELY",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "54308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.