NPIMap

Individual provider Active NPI

Allison Marie Homstad Juba, DO

  • Family Medicine Physician
  • Alexandria, MN
National Provider Identifier
1356870174
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64351 Issued in MN
Practice address
610 30TH Ave W
Alexandria, MN 56308-3426
Phone
(320) 763-2540
Fax
(320) 763-7883
NPI assigned
Jun 6, 2017
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 64351 MN
Family Medicine Physician 207Q00000X 64351 MN Primary

Addresses

Primary practice location

610 30TH Ave W
Alexandria, MN 56308-3426

Mailing address

610 30TH Ave W
Alexandria, MN 56308-3426
Phone (320) 763-2540

Other practice location 1

111 17th Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Other names 1

  • Allison Marie Homstad 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
I20190307002542 MN Practitioner - Family PracticePractitioner - Emergency Medicine 8527307628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

610 30TH Ave W
Alexandria, MN 56308-3426
Phone (320) 763-5123

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Hospital Current Accepting new patients
Alexandria Clinic PA Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
Douglas County Hospital Past Accepting new patients
Knute Nelson Past Accepting new patients
Duluth Graduate Medical Education Council Inc Family Medicine PastSince Jun 22, 2004 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

610 30th Ave W
Alexandria, MN 56308
Phone (320) 763-2540

Interoperability endpoints

  • Direct secure messaging: ajuba520388@direct.centracare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vivie Home HealthAlexandria, MN, CCN 248096 Home health agency Contracted Managing Employee Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Knute Nelson

    dba Knute Nelson Home Health

    • Home Health Agency
    • Alexandria, MN
    • NPI 1477676229

    Contracted Managing Employee

    CMS ownership

Organizations & group practices 9

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 7

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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1356870174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-2540",
            "fax_number": "320-763-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-2540",
            "fax_number": "320-763-7883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 17th Ave E",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "MN",
            "postal_code": "563085273",
            "country_code": "US",
            "telephone_number": "320-762-1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUBA",
        "first_name": "ALLISON",
        "middle_name": "MARIE HOMSTAD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "64351",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "64351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "HOMSTAD",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.