Jessica Mae Daigle

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10976 Issued in MN

Practice address

5500 94TH Ave N
Brooklyn Park, MN 55443-1992

Phone

(952) 826-8475

Fax

(763) 315-6685

NPI assigned

Nov 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• St. Croix Psychiatric, LLC

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  Medicare reassignment Care Compare group NPD
• Prairiecare LLC

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928
  NPD (past)

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1295500353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30058 107TH AVE N",
            "city": "HANOVER",
            "state": "MN",
            "postal_code": "553419702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 94TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431992",
            "telephone_number": "952-826-8475",
            "fax_number": "763-315-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crown Medical Center
• Crunch Cleaners LLC
• Crystal Edge LLC
• Jonathan Michael Czech, RPH
• D and V Enterprise, Inc
• Farah Dalmar
• Dane Technologies, Inc.
• Mary Hong Dao, APRN, CNP
• Monia Davies
• Lindsey Dawes, DNP, APRN, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.