NPIMap

Individual provider Active NPI

Jenna Haugo

  • Nurse Practitioner
  • Saint Michael, MN
National Provider Identifier
1144618885
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
V542285958911 Issued in MN
Practice address
4300 Edgewood Dr NE
Saint Michael, MN 55376-4588
Phone
(763) 744-4000
NPI assigned
Jan 5, 2015
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X V542285958911 MN Primary

Addresses

Primary practice location

4300 Edgewood Dr NE
Saint Michael, MN 55376-4588

Mailing address

110943 Von Hertzen Cir
Chaska, MN 55318-2714
Phone (763) 219-6682

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhaugo104214@excellian.direct.allina.com Direct

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
I20150409002665 MN Practitioner - Nurse Practitioner 6507184165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1324 5TH St N
New Ulm, MN 56073-1514
Phone (507) 217-5199

200 State Ave
Faribault, MN 55021-6339
Phone (507) 334-6451

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3612MNMDMarriage & Family Therapist
V542285958911MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Feb 17, 2015 Accepting new patients
Allina Health System CurrentSince Feb 17, 2015 Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

4300 Edgewood Dr NE
Saint Michael, MN 55376
Phone (763) 744-4000

Interoperability endpoints

  • Direct secure messaging: jhaugo104214@excellian.direct.allina.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1144618885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110943 VON HERTZEN CIR",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182714",
            "telephone_number": "763-219-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 EDGEWOOD DR NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553764588",
            "telephone_number": "763-744-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGO",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "V542285958911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhaugo104214@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4300 Edgewood Dr NE",
            "city": "Saint Michael",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553764588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Michael, MN

Sources for this page

Verify at the official NPI Registry.