Katrina Margaret Jackson, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2397795 Issued in MN

Practice address

1580 Beam Ave
Maplewood, MN 55109-1127

Phone

(651) 779-7978

Fax

(651) 779-7656

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Katrina Margaret Cirilli Former name

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: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
• Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

Merit-based Incentive Payment System (MIPS)

Final score

89.19 of 100Reported as apm

Quality

72.34

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katrina.jackson@moh.ikm.direct-ci.com

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.

• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1528035995

  WI

  Medicare reassignment Care Compare group NPD
• Minnesota Oncology Hematology PA

  • Community/Retail Pharmacy
  • Maple Grove, MN
  • NPI 1811601123
  NPD
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Woodbury, MN
  • NPI 1427191824

  Nurse Practitioner

  NPD
• Minnesota Oncology Hematology PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1205606316

  Nurse Practitioner

  NPD (past)
• Minnesota Oncology Hematology, PA

  • Radiation Oncology Physician
  • Saint Paul, MN
  • NPI 1598305427
  NPD (past)
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1609911205

  Nurse Practitioner

  NPD (past)
• Oncology Hematology Care Inc

  • Medical Oncology Physician
  • Cincinnati, OH
  • NPI 1790778041
  NPD (past)

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

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Woodbury, MN
  • NPI 1063668937

  Hospital

  Care Compare affiliation
• Allina Health System

  • Neurological Surgery Physician
  • Minneapolis, MN
  • NPI 1144264540

  Hospital

  Care Compare affiliation
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Paul, MN
  • NPI 1265474704

  Hospital

  Care Compare affiliation
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Saint Paul, MN
  • NPI 1275789091

  Hospital

  Care Compare affiliation
• Allina Health System

  • Oncology Clinic/Center
  • Saint Paul, MN
  • NPI 1295182855

  Hospital

  Care Compare affiliation
• Allina Health System

  • Specialist
  • St Paul, MN
  • NPI 1447550702

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1457319485
  Care Compare affiliation
• Allina Health System

  • Orthopaedic Surgery Physician
  • Edina, MN
  • NPI 1508099656

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Hastings, MN
  • NPI 1508457045
  Care Compare affiliation
• Allina Health System

  • Clinic/Center
  • St Paul, MN
  • NPI 1518173319

  Hospital

  Care Compare affiliation
• Allina Health System

  • Cardiovascular Disease Physician
  • Saint Paul, MN
  • NPI 1588929079

  Hospital

  Care Compare affiliation
• Allina Health System

  • Neurological Surgery Physician
  • Saint Paul, MN
  • NPI 1619914207

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1588979306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 110N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551142001",
            "telephone_number": "651-602-5309",
            "fax_number": "651-222-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091127",
            "telephone_number": "651-779-7978",
            "fax_number": "651-779-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATRINA",
        "middle_name": "MARGARET",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704285871",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "11676",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2397795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201010130",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100132960",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080713",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "CIRILLI",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Isd 622 Gladstone Meals on Wheels
• Alexander Ivaskovic, MD
• Kathleen Ann Iverson, LDH
• Sanaz Jabbari, DDS
• Danielle Margaret Colette Jackson, MD
• Thomas R. Jacques, M.D.
• Raeann Jaeb, OTR/L
• Laura Lea Jaeger, DPT
• Michael J Jaeger, PA-C
• Thyra Jagger

• Nurse Practitioner in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.

Verify at the official NPI Registry.