Jason John Hansen, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

51714 Issued in MN

Practice address

407 East 3Rd Street
St. Mary's Medical Center
Duluth, MN 55805

Phone

(218) 786-4357

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Essentia Health Moose Lake

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1154959880
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  dba Essentia Health Virginia

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment NPD
• Northern Pines Medical Center

  dba Essentia Health Northern Pines

  • Critical Access Hospital
  • Aurora, MN
  • NPI 1639278609
  Medicare reassignment NPD
• Pine Medical Center

  dba Essentia Health Sandstone

  • Critical Access Hospital
  • Sandstone, MN
  • NPI 1326041633
  Medicare reassignment NPD
• St Marys Medical Center

  dba Essentia Health St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Medicare reassignment NPD
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment NPD
• Essentia Health Moose Lake

  dba Essentia Health Moose Lake Clinic

  • Critical Access Hospital Clinic/Center
  • Moose Lake, MN
  • NPI 1275102048
  NPD
• Moose Lake Community Hospital District

  dba Mercy Hospital

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1942398029
  NPD
• Northern Pines Medical Center

  dba Essentia Health Northern Pines Clinic

  • Rural Health Clinic/Center
  • Aurora, MN
  • NPI 1285183046
  NPD
• Northern Pines Medical Center

  dba Essentia Health Northern Pines Clinic

  • Critical Access Hospital Clinic/Center
  • Aurora, MN
  • NPI 1881954147
  NPD
• Pine Medical Center

  dba Essentia Health Hinckley Clinic

  • Multi-Specialty Clinic/Center
  • Hinckley, MN
  • NPI 1720859531
  NPD
• St. Mary's Medical Center

  dba Essentia Health St. Mary's Heart and Vascular Center

  • Clinic/Center
  • Duluth, MN
  • NPI 1821835851
  NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1447467220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 EAST 3RD STREET",
            "address_2": "ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 EAST 3RD STREET",
            "address_2": "ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JASON",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "51714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447467220",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447467220",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Marissa Hansen, DPT
• Emma Claire Hansen
• Erin Marie Hansen
• Ernest Carl Hansen, P.T.
• Hayley Hansen
• Jennifer Lynn Hansen, APRN, CNP
• Lindsay Rae Hansen
• Steven J. Hansen, MD
• Todd Hansen, DDS
• Jacquelyn Kaye Hanson-Hietala, LGSW

• Emergency Medicine Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.