NPIMap

Individual provider Active NPI

Jesse Jacobs

  • Urology Physician
  • Saint Paul, MN
National Provider Identifier
1457779555
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
67498 Issued in MN
Practice address
435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(651) 254-8500
NPI assigned
Apr 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 67498 MN Primary
Urology Physician 208800000X 201901598 NC
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

435 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (651) 254-8500

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
I20200808000083 MN Practitioner - Urology 9638471600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201901598NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Aug 24, 2020 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

233 Radio Dr
Woodbury, MN 55125
Phone (651) 254-7400

Interoperability endpoints

  • Direct secure messaging: jjacobs267116@direct.healthpartners.com

Organizations & group practices 2

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1457779555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "67498",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "201901598",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.