NPIMap

Individual provider Active NPI

Jay M Schmidt, M.D.

  • Family Medicine Physician
  • Graceville, MN
National Provider Identifier
1215936455
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46406 Issued in MN
Practice address
115 W 2ND St
Graceville, MN 56240-4803
Phone
(320) 748-7243
Fax
(320) 748-8204
NPI assigned
Jul 19, 2005
Last updated
Nov 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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 46406 MN Primary

Addresses

Primary practice location

115 W 2ND St
Graceville, MN 56240-4803

Mailing address

115 W 2ND St
Graceville, MN 56240-4803
Phone (320) 748-7243

Other identifiers 2

IdentifierTypeStateIssuer
166K7SCOtherMNBLUE CROSS BLUE SHIELD MN
812980100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031204000176 MN Practitioner - Family Practice 0648175547 Reassigns benefits to 2 organizations
I20041110000750 WY Practitioner - Family Practice 0648175547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graceville Health CenterGroup PAC ID 4385556885, 5 clinicians

Practice addresses (Care Compare)

115 W 2ND St
Graceville, MN 56240-4845
Phone (320) 748-7223

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graceville Health Center CurrentSince Oct 27, 2003 Accepting new patients
Graceville Health Center CurrentSince Oct 27, 2003 Accepting new patients
Graceville Health Center Current Accepting new patients
Ortonville Area Health Services Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Essentia Health Grace HomeGraceville, MN, CCN 245579B Skilled nursing facility Corporate Director
Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024
Jan 1, 2024

Owned or controlled facilities with NPI records 1

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

  • Graceville Health Center

    dba Essentia Health - Grace Home

    • Skilled Nursing Facility
    • Graceville, MN
    • NPI 1699744128

    Adp of the SNF, Corporate Director, Operational/Managerial Control

    CMS ownership

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1215936455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 2ND ST",
            "city": "GRACEVILLE",
            "state": "MN",
            "postal_code": "562404803",
            "telephone_number": "320-748-7243",
            "fax_number": "320-748-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 2ND ST",
            "city": "GRACEVILLE",
            "state": "MN",
            "postal_code": "562404803",
            "telephone_number": "320-748-7243",
            "fax_number": "320-748-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JAY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "166K7SC",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812980100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Graceville, MN

Sources for this page

Verify at the official NPI Registry.