Jacob David Kastner, D.O.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

71921-21 Issued in WI

Practice address

911 Northland Dr
Princeton, MN 55371-2172

Phone

(763) 389-6353

NPI assigned

Mar 20, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Sports MedicineAlso: Physical Medicine and Rehabilitation

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkastner733819@fairview.direct-ci.com

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Fairview Specialty Services

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1588543862
  Medicare reassignment Care Compare group
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1841315165
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  • Eyewear Supplier
  • Fridley, MN
  • NPI 1942482740
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1730586819
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD

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

• Fairview Health Services

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1841351749
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  Care Compare affiliation

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1124569413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 NORTHLAND DR",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553712172",
            "telephone_number": "763-389-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 NORTHLAND DR",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553712172",
            "telephone_number": "763-389-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTNER",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WI",
            "license": "71921-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavonne Irene Johnson, MT
• Steven R Johnson, MD
• Craig S Jones II, DO
• Glenn Orville Kallevig, O.D.
• Brianna Elaine Kastner
• James T Katter, MD
• Joseph Kelley
• Jacqueline Kelly-Faddler, MS, LPCC
• Bobbi Kelton
• Tyler Kemnitz, PT

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Princeton, MN
• Providers in Princeton, MN by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.

Verify at the official NPI Registry.