Individual provider Active NPI

Jessica L Grajczyk, DO

  • Obstetrics & Gynecology Physician
  • Edina, MN
National Provider Identifier
1154531192
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
51920 Issued in MN
Practice address
6405 France Ave. South
Suite W400
Edina, MN 55435-2192
Phone
(952) 920-2730
Fax
(952) 567-7090
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 51920 MN Primary

Addresses

Primary practice location

6405 France Ave. South
Suite W400
Edina, MN 55435-2192

Mailing address

6405 France Ave S Ste W400
Edina, MN 55435-2165
Phone (952) 920-2730

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
I20100210000625 MN Practitioner - Obstetrics/Gynecology 6406999697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51920MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2020 Accepting new patients
Infinite Health Collaborative, PA Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Aug 1, 2010 Accepting new patients
Fairview Health Services Current Accepting new patients
Obstetrics and Gynecology Associates, P.a. Obstetrics & Gynecology CurrentSince Jan 1, 2011 Accepting new patients
Fairview Health Services CurrentSince Aug 1, 2010 Accepting new patients

Locations

305 E Nicollet Blvd
Ste 170
Burnsville, MN 55337
Phone (952) 435-4190

6405 France Ave S
Ste 400
Minneapolis, MN 55435

6565 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 806-0011

6405 France Ave S
Ste W400
Minneapolis, MN 55435
Phone (952) 920-2730

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Organizations & group practices 7

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1154531192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S STE W400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352165",
            "telephone_number": "952-920-2730",
            "fax_number": "952-567-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE. SOUTH",
            "address_2": "SUITE W400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352192",
            "telephone_number": "952-920-2730",
            "fax_number": "952-567-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJCZYK",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "51920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.