Individual provider Active NPI

Jaime Wirth, M.D.

  • Family Medicine Physician
  • Wyoming, MN
National Provider Identifier
1386935229
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55512 Issued in MN
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7600
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55512 MN Primary

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

580 Rice St
Saint Paul, MN 55103-2148
Phone (651) 227-6551

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
I20120806000045 MN Practitioner - Family Practice 0648426718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55512MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Sep 8, 2014 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Sep 8, 2014 Accepting new patients
Fairview Clinics CurrentSince Oct 21, 2014 Accepting new patients
Fairview Clinics CurrentSince Oct 21, 2014 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: jwirth64054@fairview.direct-ci.com

Organizations & group practices 10

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 4

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": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1386935229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032148",
            "telephone_number": "651-227-6551",
            "fax_number": "651-227-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "JAIME",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.