Individual provider Active NPI

Jennifer K Lessman, PA-C

  • Medical Physician Assistant
  • Detroit Lakes, MN
National Provider Identifier
1205875598
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10026 Issued in MN
Practice address
1245 Washington Ave S
Detroit Lakes, MN 56501
Phone
(218) 846-2000
Fax
(218) 846-2114
NPI assigned
Jun 5, 2006
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10026 MN Primary

Addresses

Primary practice location

1245 Washington Ave S
Detroit Lakes, MN 56501

Mailing address

1245 Washington Ave S
Detroit Lakes, MN 56501
Phone (218) 846-2000

Other identifiers 3

IdentifierTypeStateIssuer
25805OtherNDBCBS
353G9NIOtherMNBCBS
615169800MedicaidMN

Other names 1

  • Jenny Nienhueser Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlessman1841797@direct.sanfordhealth.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050721000206 MN Practitioner - Physician Assistant 3870520869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10026MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 20, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 20, 2022 Accepting new patients
Mahube-Otwa Community Action Partnership PastSince Nov 21, 2015 Accepting new patients
St. Marys Regional Health Center Past Accepting new patients
Sanford Health of Northern Minnesota Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000

414 W Jefferson Ave
Mahnomen, MN 56557
Phone (218) 935-2511

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

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, 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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1205875598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE S",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "56501",
            "telephone_number": "218-846-2000",
            "fax_number": "218-846-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE S",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "56501",
            "telephone_number": "218-846-2000",
            "fax_number": "218-846-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSMAN",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBCBS",
            "identifier": "25805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBCBS",
            "identifier": "353G9NI",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "615169800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlessman1841797@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1245 WASHINGTON AVE S",
            "city": "DETROIT LAKES",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "NIENHUESER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.