Individual provider Active NPI

Jason R Maxwell-Wiggins, MD

  • Pediatrics Physician
  • Saint Paul, MN
National Provider Identifier
1215905427
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
45055 Issued in MN
Practice address
2500 Como Ave
Saint Paul, MN 55108
Phone
(651) 641-6200
Fax
(651) 641-6205
NPI assigned
Mar 14, 2006
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 45055 MN Primary

Addresses

Primary practice location

2500 Como Ave
Saint Paul, MN 55108

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other names 1

  • Jason R Maxwell Other name

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
I20080403000439 MN Practitioner - Pediatric Medicine 9032296868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Mayo Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

11475 Robinson Dr NW
Coon Rapids, MN 55433-3746
Phone (763) 754-0041

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900

205 Wabasha Ave S
Saint Paul, MN 55107-1805

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

2831 Snelling N Ave
Roseville, MN 55113-2460
Phone (651) 636-4525

576 Apollo Dr
Lino Lakes, MN 55014-3004
Phone (651) 784-1611

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Mar 26, 2012 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Mar 26, 2012 Accepting new patients
Regions Hospital Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

205 Wabasha St S
Stop 31300A
Saint Paul, MN 55107
Phone (651) 293-8100

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regions HospitalSaint Paul, MN, CCN 24T106 Hospital Corporate Officer May 1, 2026
Regions HospitalSaint Paul, MN, CCN 24S106 Hospital Corporate Director May 1, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1215905427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55108",
            "telephone_number": "651-641-6200",
            "fax_number": "651-641-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL-WIGGINS",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "45055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "MAXWELL",
            "middle_name": "R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.