Dylan H Jackson, PA
Individual provider Active NPI Physician Assistant · Edina, MN
NPI 1124783709 · NPPES record last updated May 2, 2022
Key facts
- NPI
- 1124783709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 8100 W 78TH St Ste 230
Edina, MN 55439-2570 - Phone
- (952) 946-9777
- Fax
- (952) 946-9888
- NPI assigned
- Nov 8, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 23
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allina Health System
Practice addresses (Care Compare)
2805 Campus Dr
Suite 465
Plymouth, MN 55441-2680
Phone (952) 946-9777
2925 Chicago Ave
Minneapolis, MN 55407-1321
440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225
6001 96TH LN N
Suite 100
Brooklyn Park, MN 55445-4602
Phone (952) 946-9777
800 E 28TH St
Minneapolis, MN 55407-3723
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220224002345 | MN | Practitioner - Physician Assistant | 6709270317 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13843 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | 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
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
8100 W 78th St
Ste 230
Minneapolis, MN 55439
Phone (888) 892-7575
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
8100 W 78TH St Ste 230
Edina, MN 55439-2570
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | djackson578278@excellian.direct.allina.com | Direct |
Other providers in Edina, MN
- Stacy Izzo
- J. Bart Muldowney MD, PA
- Jennifer J'Creo
- Kenzie Jackley
- Todd Edward Jackman
- John Clarke Jackson
- Mary Anne Jacob
- Annabel Jacobs
- Katherine Marie Jacobs
- Maggie Jacobs
All providers in Edina, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.