NPIMap

Individual provider Active NPI

Jayson Carl Dock, M.D.

  • Surgery Physician
  • Shakopee, MN
National Provider Identifier
1316979891
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.083906 Issued in OH
Practice address
1601 Saint Francis Ave
Suite 100
Shakopee, MN 55379-3383
Phone
(952) 428-3535
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.083906 OH Primary

Addresses

Primary practice location

1601 Saint Francis Ave
Suite 100
Shakopee, MN 55379-3383

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

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
I20100820000494 MN Practitioner - General SurgeryPractitioner - General Practice 9335237957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux51
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.083906OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
St Francis Regional Medical Center Past Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

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

920 E 28th St
Ste 460
Minneapolis, MN 55407
Phone (612) 863-7501

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

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

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

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

310 Smith Ave N
Ste 180
Saint Paul, MN 55102
Phone (651) 241-7800

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

Interoperability endpoints

  • Direct secure messaging: jdock106528@excellian.direct.allina.com

Organizations & group practices 7

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 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1316979891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SAINT FRANCIS AVE",
            "address_2": "SUITE 100",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793383",
            "telephone_number": "952-428-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCK",
        "first_name": "JAYSON",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.083906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.