Individual provider Active NPI

John Philip Wust III, MD

  • Obstetrics & Gynecology Physician
  • Blaine, MN
National Provider Identifier
1366443707
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38586 Issued in MN
Practice address
10705 Town Square Dr NE Ste 100
Blaine, MN 55449-8185
Phone
(763) 236-5400
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 38586 MN Primary

Addresses

Primary practice location

10705 Town Square Dr NE Ste 100
Blaine, MN 55449-8185

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
266318000MedicaidMN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322000241 MN Practitioner - Obstetrics/Gynecology 7719976968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38586MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Obstetrics & Gynecology Current Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System CurrentSince Jan 18, 2023 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients
Northern OB GYN Associates PC Obstetrics & Gynecology PastSince Dec 13, 2004 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

7840 Vinewood Ln N
Maple Grove, MN 55369
Phone (763) 236-0200

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

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

11855 Ulysses St NE
Minneapolis, MN 55434
Phone (763) 420-1010

10705 Town Square Dr NE
Ste 100
Minneapolis, MN 55449
Phone (763) 236-5400

480 Osborne Rd NE
Ste 100
Minneapolis, MN 55432
Phone (763) 785-4500

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

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

2805 Dodd Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 241-7733

347 Smith Ave N
Ste 203
Saint Paul, MN 55102
Phone (651) 241-7733

Interoperability endpoints

  • Direct secure messaging: jwust90251@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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321142400000",
    "number": "1366443707",
    "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": "10705 TOWN SQUARE DR NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554498185",
            "telephone_number": "763-236-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUST",
        "first_name": "JOHN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "38586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266318000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.