Active NPI
Jake S Jasurda
- Gastroenterology Physician
- Lakeville, MN
National Provider Identifier
1578096350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 156183
- Practice address
- 18465 Orchard TRL Ste 320
Lakeville, MN 55044-2522 - Phone
- (612) 871-1145
- Fax
- (612) 870-5491
- NPI assigned
- Apr 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 156183 | IL | Primary |
Addresses
Primary practice location
18465 Orchard TRL Ste 320
Lakeville, MN 55044-2522
Mailing address
PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
18465 Orchard TRL
Suite 320
Lakeville, MN 55044-2522
Phone (612) 871-1145
Hospital & facility affiliations
- Abbott Northwestern Hospital
- M Health Fairview Ridges Hospital
- Allina United Hospital
- M Health Fairview Southdale Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 59 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 75 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 156183 | IL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mngi Digestive Health, P.a. | Gastroenterology | Current | Accepting new patients |
| Loyola University Medical Center | Current | Accepting new patients |
Locations
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100
Interoperability endpoints
- jjasurda139851@direct.luhs.org
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- jake.jasurdamd.p1@direct.mngastro.nextgenshare.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.
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1609804541
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
Hospital & facility affiliations 40
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1578096350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14909",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554140909",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18465 ORCHARD TRL STE 320",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550442522",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASURDA",
"first_name": "JAKE",
"middle_name": "S",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-07",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "156183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.