Individual provider Active NPI

Jaclyn J Bohm, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rosemount, MN
National Provider Identifier
1306005111
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
842 Issued in MN
Practice address
15705 Cimarron Ave
Rosemount, MN 55068
Phone
(651) 322-8800
Fax
(651) 322-8840
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 842 MN Primary

Addresses

Primary practice location

15705 Cimarron Ave
Rosemount, MN 55068

Mailing address

15075 Cimarron Ave
Rosemount, MN 55068-1635
Phone (651) 322-8800

Other names 1

  • Jaclyn J Scheve Former name

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110728000455 MN Practitioner - Podiatry 2466620968 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Suite 300
Burnsville, MN 55337-2537
Phone (952) 460-4000

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

45 10TH St W
Saint Paul, MN 55102-1062

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue46
Removal of nail tissue41
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Jul 8, 2011 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 8, 2011 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jul 8, 2011 Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

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

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

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

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

15075 Cimarron Ave
Rosemount, MN 55068
Phone (651) 322-8800

3305 Central Park Village Dr
#200
Saint Paul, MN 55121

3305 Central Park Village Dr
#130
Saint Paul, MN 55121

Interoperability endpoints

  • Direct secure messaging: jbohm206089@fairview.direct-ci.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.

Hospital & facility affiliations 5

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1306005111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15075 CIMARRON AVE",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681635",
            "telephone_number": "651-322-8800",
            "fax_number": "651-322-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15705 CIMARRON AVE",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "55068",
            "telephone_number": "651-322-8800",
            "fax_number": "651-322-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHM",
        "first_name": "JACLYN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SCHEVE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rosemount, MN

Sources for this page

Verify at the official NPI Registry.