NPIMap

Individual provider Active NPI

Christina H. Bastin Dejong, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Duluth, MN
National Provider Identifier
1306028410
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
50210 Issued in MN
Practice address
400 E. 3Rd St.
Duluth Clinic
Duluth, MN 55805
Phone
(218) 786-3993
NPI assigned
Nov 30, 2007
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50210 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 50210 MN Primary

Addresses

Primary practice location

400 E. 3Rd St.
Duluth Clinic
Duluth, MN 55805

Mailing address

400 E. 3Rd St.
Duluth Clinic
Duluth, MN 55805
Phone (218) 786-3993

Other names 1

  • Christina H Dejong Former name

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
I20080623000031 MN Practitioner - Critical Care (Intensivists) 4587735337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
University of Minnesota Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

402 E 2ND St
Duluth, MN 55805-1906
Phone (218) 786-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50210MNMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph's Medical Center CurrentSince Jan 1, 2021 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 27, 2008 Accepting new patients
The Duluth Clinic, LTD CurrentSince May 27, 2008 Accepting new patients
St Joseph's Medical Center CurrentSince Jan 1, 2021 Accepting new patients
St. Joseph's Medical Center Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1306028410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E. 3RD ST.",
            "address_2": "DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E. 3RD ST.",
            "address_2": "DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIN DEJONG",
        "first_name": "CHRISTINA",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "50210",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "50210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DEJONG",
            "middle_name": "H",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.