NPIMap

Individual provider Active NPI

Jesse M Manunga Jr., M.D.

  • Vascular Surgery Physician
  • Minneapolis, MN
National Provider Identifier
1376730093
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
54508 Issued in MN
Practice address
920 E 28TH St
Suite 300
Minneapolis, MN 55407-1139
Phone
(612) 863-6800
Fax
(612) 863-6006
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 54508 MN Primary

Addresses

Primary practice location

920 E 28TH St
Suite 300
Minneapolis, MN 55407-1139

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmanunga206725@excellian.direct.allina.com Direct

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
I20110824000888 MN Practitioner - Vascular Surgery 4789854043 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of California, Geffen School of Medicine, 2006
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)

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (621) 775-6200

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • New Ulm Medical Center Hospital, New Ulm, MN, CCN 241378
  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056
  • Buffalo Hospital Hospital, Buffalo, MN, CCN 240076

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
Spinal fusion60
Laminectomy or laminotomy (partial removal of spine bones)1-10
Leg revascularization (restoring blood flow)16
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 12, 2014 Accepting new patients
Allina Health System Current Accepting new patients
Minneapolis Heart Institute at Ridgeview Heart Center, LLC CurrentSince Oct 1, 2019 Accepting new patients
Allina Health System CurrentSince Aug 12, 2014 Accepting new patients
Allina Health System CurrentSince Dec 25, 2024 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

111 Hundertmark Rd
Ste 303N
Chaska, MN 55318
Phone (952) 442-7843

920 E 28th St
Ste 300
Minneapolis, MN 55407
Phone (612) 863-3900

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

920 E 28th St
Ste 610
Minneapolis, MN 55407
Phone (612) 863-6900

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

7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311

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

424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461

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.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1376730093",
    "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": "920 E 28TH ST",
            "address_2": "SUITE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071139",
            "telephone_number": "612-863-6800",
            "fax_number": "612-863-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUNGA",
        "first_name": "JESSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "54508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmanunga206725@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "920 E 28th St",
            "address_2": "Suite 300",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.