Jackson Newcomer

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

77758 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905-0001

Phone

(507) 284-2511

NPI assigned

Mar 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jack Newcomer Professional name

Electronic endpoints 1

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

Specialty

Dermatology

Education

University of Kentucky College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment Care Compare group NPD
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD
• Mayo Clinic

  • Infectious Disease Physician
  • Rochester, MN
  • NPI 1114343860
  NPD

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

• Mayo Clinic Hospital-Rochester

  • General Acute Care Hospital
  • Rochester, MN
  • NPI 1841266194
  Care Compare affiliation

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1275283103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMER",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "77758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnewcomer1784122@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "NEWCOMER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• New Leaf Therapy PLLC
• Richard D Newcomb, M.D.
• Marci D Newcome, CNP
• Karen L Newcomer Aney, M.D.
• Albert Dallas Newcomer, M.D.
• Ashlee D Newhart, LPCC
• Elizabeth Newman Ehman, MA
• Carolyn Newman Naranjo, D.O.
• Darrell Brian Newman, M.D.
• Deborah C Newman, M.D.

• Dermatology Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.