Active NPI
Jonathan Robert Sande, MD
- Hematology & Oncology Physician
- Cloquet, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 36412
- Practice address
- 512 Skyline Blvd Ste 1
Cloquet, MN 55720-1199 - Phone
- (218) 879-4641
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician | 207RH0000X | 36412 | MN | |
| Medical Oncology Physician | 207RX0202X | 36412 | MN | |
| Hematology & Oncology Physician | 207RH0003X | 36412 | MN | Primary |
Addresses
Primary practice location
512 Skyline Blvd Ste 1
Cloquet, MN 55720-1199
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
1233 34th St NW
Bemidji, MN 56601-5112
Phone (218) 333-5522
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32448000 | Medicaid | WI | |
| 085525100 | Medicaid | MN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hisdept@direct.cloquethospital.com | ||
| Direct Messaging Address | jsande678337@direct.centracare.com | Direct |
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Mayo Medical School, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641
Hospital & facility affiliations
- Community Memorial Hospital
- Wilcox Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36412 | MN | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Memorial Hospital Association | Current | Accepting new patients | |
| Carris Health LLC | Current | Accepting new patients | |
| Kauai Medical Clinic | Current | Accepting new patients | |
| Kauai Medical Clinic | Current | Accepting new patients | |
| Carris Health LLC | Hematology & Oncology | Current | Accepting new patients |
| Community Memorial Hospital Association | Past | Accepting new patients |
Locations
3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500
512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207
512 Skyline Blvd
Ste 1
Cloquet, MN 55720
Phone (218) 879-4641
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120
Interoperability endpoints
- jsande678337@direct.centracare.com
- hisdept@direct.cloquethospital.com
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 and National Provider Directory roles.
-
- Critical Access Hospital
- Cloquet, MN
- NPI 1003869082
-
- Durable Medical Equipment & Medical Supplies
- Willmar, MN
- NPI 1427684612
-
- Multi-Specialty Clinic/Center
- Lihue, HI
- NPI 1376596643
-
- Durable Medical Equipment & Medical Supplies
- Koloa, HI
- NPI 1871611558
-
- Dialysis Equipment & Supplies (DME)
- Cloquet, MN
- NPI 1528103652
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Cloquet, MN
- NPI 1003869082
-
- Rural Acute Care Hospital
- Lihue, HI
- NPI 1225113442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1316970536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 SKYLINE BLVD STE 1",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201199",
"telephone_number": "218-879-4641"
}
],
"practiceLocations": [
{
"address_1": "1233 34th St NW",
"address_purpose": "LOCATION",
"city": "Bemidji",
"state": "MN",
"postal_code": "566015112",
"country_code": "US",
"telephone_number": "218-333-5522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDE",
"first_name": "JONATHAN",
"middle_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "MN",
"license": "36412",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "MN",
"license": "36412",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MN",
"license": "36412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32448000",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "085525100",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hisdept@direct.cloquethospital.com",
"affiliation": "N",
"address_1": "512 Skyline Blvd Ste 1",
"city": "Cloquet",
"state": "MN",
"country_code": "US",
"postal_code": "557201199",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jsande678337@direct.centracare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jsande678337@direct.centracare.com",
"address_1": "301 Becker Ave SW",
"city": "Willmar",
"state": "MN",
"country_code": "US",
"postal_code": "562013302",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.