Jacqueline Huber, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

67356 Issued in MN

Practice address

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Phone

(218) 739-2221

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cow Creek Band of Umpqua Tribe of IndiansGroup PAC ID 8921099474, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052

Merit-based Incentive Payment System (MIPS)

Final score

88.64 of 100Reported as group

Quality

86.84

Promoting interoperability

100

Improvement activities

40

Cost

75.29

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

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.

• Cow Creek Band of Umpqua Tribe of Indians

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1063502714

  TX

  Medicare reassignment Care Compare group NPD
• Lake Region Healthcare Corporation

  • General Acute Care Hospital
  • Fergus Falls, MN
  • NPI 1093713372
  NPD
• Lake Region Healthcare Corporation

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1265148480
  NPD
• Cow Creek Band of Umpqua Tribe of Indians

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
  • NPI 1134567993
  NPD (past)

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1356799209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 39TH ST S APT 206",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034419",
            "telephone_number": "701-220-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-2221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 Elm St N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581022416",
            "country_code": "US",
            "telephone_number": "701-293-4113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "67356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorri Holt
• Jeffrey A Horak, MD
• Hospitality House of Dayton Lake
• Carrol Jean Hotakainen, LPN
• Lyle Dean Hoxtell, LAC
• Jenna Huffman
• Jennifer Hultin
• Jacob Isaac Ihle, DDS
• Independent School District 544
• Madeline Kathleen Doyle Iversen

• Psychiatry Physician in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.