Individual provider Active NPI

Justin Gregory Hammar, MD

  • Neonatal-Perinatal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1427437102
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
63976 Issued in MN
Practice address
2104 22ND Ave S Apt 1
Minneapolis, MN 55404-3171
Phone
(612) 414-2363
NPI assigned
May 27, 2015
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 63976 MN Primary

Addresses

Primary practice location

2104 22ND Ave S Apt 1
Minneapolis, MN 55404-3171

Mailing address

2104 22ND Ave S Apt 1
Minneapolis, MN 55404-3171

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
I20220504000946 MN Practitioner - Pediatric MedicinePractitioner - Other (Physician) 9335453653 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63976MNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Apr 1, 2022 Accepting new patients
Carris Health LLC CurrentSince Apr 1, 2022 Accepting new patients
Centracare Clinic CurrentSince Apr 1, 2022 Accepting new patients
Carris Health LLC CurrentSince Apr 1, 2022 Accepting new patients
St. Cloud Hospital Past Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
St Cloud Medical Group PA Past Accepting new patients

Locations

2450 Riverside Ave
Rm MB630
Minneapolis, MN 55454

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: jhammar588241@direct.centracare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1427437102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 22ND AVE S APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 22ND AVE S APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043171",
            "telephone_number": "612-414-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMAR",
        "first_name": "JUSTIN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "63976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.