NPIMap

Individual provider Active NPI

Jamie Don Lauwagie, MD

  • Family Medicine Physician
  • Deerwood, MN
National Provider Identifier
1154950962
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
73874 Issued in MN
Practice address
24087 Cuyuna St
Deerwood, MN 56444-3301
Phone
(182) 833-5160
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 73874 MN Primary

Addresses

Primary practice location

24087 Cuyuna St
Deerwood, MN 56444-3301

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

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
I20230908002407 MN Practitioner - Family Practice 1951723311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota, Duluth School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

24087 Cuyuna St
Deerwood, MN 56444-3301
Phone (218) 833-5160

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73874MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph's Medical Center CurrentSince Sep 11, 2023 Accepting new patients
St. Joseph's Medical Center Current Accepting new patients
St Joseph's Medical Center CurrentSince Sep 11, 2023 Accepting new patients
St. Joseph's Medical Center Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

24087 Cuyuna St
Deerwood, MN 56444
Phone (218) 833-5160

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

280 Barclay Ave W
Pine River, MN 56474
Phone (218) 587-3222

Organizations & group practices 4

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 11

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1154950962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24087 CUYUNA ST",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "564443301",
            "telephone_number": "182-833-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUWAGIE",
        "first_name": "JAMIE",
        "middle_name": "DON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "73874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerwood, MN

Sources for this page

Verify at the official NPI Registry.