NPIMap

Individual provider Active NPI

Jacob Joseph Wilson, MD

  • Psychiatry Physician
  • Hastings, MN
National Provider Identifier
1265871701
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
58267 Issued in MN
Practice address
1880 N Frontage Rd
Hastings, MN 55033-2687
Phone
(651) 438-1800
NPI assigned
Jun 18, 2013
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 58267 MN Primary

Addresses

Primary practice location

1880 N Frontage Rd
Hastings, MN 55033-2687

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-4400

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
I20140821000325 MN Practitioner - Psychiatry 9931341278 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Saint Louis University School of Medicine, 2013
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

Practice addresses (Care Compare)

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (651) 438-1800

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58267MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Fairview Express Care CurrentSince Dec 11, 2017 Accepting new patients
Allina Health System Current Accepting new patients
Winona Health Services CurrentSince Jan 1, 2016 Accepting new patients
Allina Health System CurrentSince Jan 9, 2023 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jan 8, 2022 Accepting new patients
Healtheast St. John's Hospital CurrentSince Jan 8, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Express Care CurrentSince Jan 8, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 8, 2022 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jan 8, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Dec 11, 2017 Accepting new patients
Fairview Express Care CurrentSince Jan 8, 2022 Accepting new patients
St. Croix Psychiatric, LLC Psychiatry CurrentSince Oct 28, 2017 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1880 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-1800

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6363 France Ave S
Minneapolis, MN 55435
Phone (952) 230-9100

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: jwilson202360@excellian.direct.allina.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1265871701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 N FRONTAGE RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550332687",
            "telephone_number": "651-438-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACOB",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "58267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

Verify at the official NPI Registry.