NPIMap

Individual provider Active NPI

Jesse Miller

  • Pulmonary Disease Physician
  • Coon Rapids, MN
National Provider Identifier
1205105525
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
58981 Issued in MN
Practice address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone
(651) 485-7668
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
Yes

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
Pulmonary Disease Physician 207RP1001X 58981 MN Primary

Addresses

Primary practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Mailing address

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (651) 485-7668

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmiller298479@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
I20150522001344 MN Practitioner - Critical Care (Intensivists) 3678893112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians
Centracare Health System - MelroseGroup PAC ID 1658270368, shared by 3 NPIs, 38 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

525 Main St W
Melrose, MN 56352-1043
Phone (320) 256-4231

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 13, 2015 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jul 13, 2015 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
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

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

225 Smith Ave N
Ste 501
Saint Paul, MN 55102
Phone (651) 241-4862

Interoperability endpoints

  • Direct secure messaging: jmiller298479@excellian.direct.allina.com

Organizations & group practices 6

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 46

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1205105525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "651-485-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "651-485-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "58981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmiller298479@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9055 Springbrook Dr NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554335841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.