Individual provider Active NPI

Jamie Otremba, C.N.M.

  • Midwife
  • Waconia, MN
National Provider Identifier
1275521692
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
R131949-9 Issued in MN
Practice address
550 S Maple St
Waconia, MN 55387-1763
Phone
(952) 442-2137
Fax
(952) 442-5960
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X R131949-9 MN Primary

Addresses

Primary practice location

550 S Maple St
Waconia, MN 55387-1763

Mailing address

550 S Maple St
Waconia, MN 55387-1763
Phone (952) 442-2137

Other identifiers 1

IdentifierTypeStateIssuer
507488600MedicaidMN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000769 MN Practitioner - Certified Nurse Midwife (CNM) 4688842271 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R131949-9MNMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Jun 26, 2017 Accepting new patients
St. Francis Regional Medical Center CurrentSince Jun 26, 2017 Accepting new patients
Allina Health System CurrentSince Jun 26, 2017 Accepting new patients
Allina Health System Current Accepting new patients
St Francis Regional Medical Center CurrentSince Jun 26, 2017 Accepting new patients
Allina Health System Past Accepting new patients
St Francis Regional Medical Center Past Accepting new patients
Metropolitan Obstetrics & Gynecology PastSince Apr 1, 2011 Accepting new patients

Locations

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

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

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

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

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

1601 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 403-3535

4201 Dean Lakes Blvd
Ste 120
Shakopee, MN 55379
Phone (952) 496-6700

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Interoperability endpoints

  • Direct secure messaging: jotremba157498@excellian.direct.allina.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1275521692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871763",
            "telephone_number": "952-442-2137",
            "fax_number": "952-442-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871763",
            "telephone_number": "952-442-2137",
            "fax_number": "952-442-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTREMBA",
        "first_name": "JAMIE",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MN",
            "license": "R131949-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507488600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.