Individual provider Active NPI

Jennifer Smith-Kristensen, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1194791756
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40812 Issued in MN
Practice address
1026 W 7TH Street
St Paul, MN 55102-3007
Phone
(651) 241-1000
NPI assigned
Feb 24, 2006
Last updated
Oct 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40812 MN Primary

Addresses

Primary practice location

1026 W 7TH Street
St Paul, MN 55102-3007

Mailing address

1026 W 7TH Street
St Paul, MN 55102-3007
Phone (651) 241-1000

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
I20080410000503 MN Practitioner - Family Practice 0446158752

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Church St SE
Minneapolis, MN 55455-0222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40812MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince May 15, 2023 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince May 15, 2023 Accepting new patients
Camden Physicians LTD. Family Medicine Past Accepting new patients

Locations

410 Church St SE
Minneapolis, MN 55455
Phone (612) 625-8400

410 Church St SE
#W235
Minneapolis, MN 55455

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1194791756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W 7TH STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551023007",
            "telephone_number": "651-241-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-KRISTENSEN",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.