NPIMap

Individual provider Active NPI

Jason Havey

  • Foot & Ankle Surgery Podiatrist
  • St Louis Park, MN
National Provider Identifier
1528455284
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1000 Issued in MN
Practice address
3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone
(952) 993-3123
Fax
(952) 993-3286
NPI assigned
Apr 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1000 MN Primary

Addresses

Primary practice location

3800 Park Nicollet Blvd
St Louis Park, MN 55416

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516

Other practice location 1

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-3123

Other practice location 2

701 Park Ave
Hennepin County Medical Center Podiatric Surgery
Minneapolis, MN 55415
Phone (612) 873-6963

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
I20180917000759 MN Practitioner - PodiatryPractitioner - Other (Physician) 4789989948 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue20
Removal of skin lesions1-10
Removal of nail tissue31
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1000MNMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Sep 9, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Sep 9, 2019 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Advanced Foot & Ankle Clinic LLC Podiatrist CurrentSince Sep 15, 2018 Accepting new patients
Advanced Foot & Ankle Clinic LLC Podiatrist CurrentSince Sep 15, 2018 Accepting new patients

Locations

14050 Fairview Dr
Burnsville, MN 55337
Phone (612) 499-8548

1225 Highway 60 W
Faribault, MN 55021
Phone (507) 334-1951

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

803 E School St
Owatonna, MN 55060
Phone (507) 334-1951

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26297/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 7

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1528455284",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-993-3123",
            "fax_number": "952-993-3286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55416",
            "country_code": "US",
            "telephone_number": "952-993-3123",
            "fax_number": "952-993-3286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_2": "Hennepin County Medical Center Podiatric Surgery",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-873-6963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVEY",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "1000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.