Individual provider Active NPI

Kelley Rae Jewett, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1396747788
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36314 Issued in MN
Practice address
409 Dunlap St N
Saint Paul, MN 55104-4201
Phone
(651) 290-9200
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 36314 MN Primary

Addresses

Primary practice location

409 Dunlap St N
Saint Paul, MN 55104-4201

Mailing address

3128 35TH Ave S
Minneapolis, MN 55406-2114
Phone (612) 729-5814

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
I20060727000410 MN Practitioner - Family Practice 1658384441 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 19, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 19, 2017 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Regents of the University of Minnesota Past Accepting new patients
Open Cities Health Center, Inc. Past Accepting new patients
Open Cities Health Center, Inc. Past Accepting new patients

Locations

6936 Pine Arbor Dr S
Ste 100
Cottage Grove, MN 55016
Phone (651) 326-5800

1215 Town Centre Dr
Eagan, MN 55123
Phone (651) 326-1515

14688 Everton Ave N
Ste 101
Hugo, MN 55038
Phone (651) 275-4706

1983 Sloan Pl
Ste 1
Saint Paul, MN 55117
Phone (651) 326-5700

2680 Snelling Ave N
Ste 200
Saint Paul, MN 55113
Phone (651) 326-1600

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

980 Rice St
Saint Paul, MN 55117
Phone (651) 326-9020

870 Grand Ave
Saint Paul, MN 55105
Phone (651) 326-5650

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1099 Helmo Ave N
Ste 100
Saint Paul, MN 55128
Phone (651) 326-5300

2900 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 471-5600

480 Highway 96 E
Vadnais Heights, MN 55127
Phone (651) 326-5900

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396747788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 35TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062114",
            "telephone_number": "612-729-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 DUNLAP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWETT",
        "first_name": "KELLEY",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.