Jose Manuel Jimenez Vega, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

70530 Issued in MN

Practice address

9680 Tamarack Rd Ste 130
Woodbury, MN 55125-2623

Phone

(651) 265-7575

Fax

(651) 265-7580

NPI assigned

Jan 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjimenezvega89816@fairview.direct-ci.com
• Direct secure messaging: jjimenezvega118741@epic00.shdirect.org

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Express Care

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• Western Michigan University School of Medicine

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1316212343
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD (past)
• Michigan State University Kalamazoo Center for Medical Studies

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1568467249
  NPD (past)

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1619208980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9680 TAMARACK RD STE 130",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9680 TAMARACK RD STE 130",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252623",
            "telephone_number": "651-265-7575",
            "fax_number": "651-265-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 1800",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032514",
            "country_code": "US",
            "telephone_number": "616-391-3933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ VEGA",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-26",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "70530",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MI",
            "license": "4301108745",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MN",
            "license": "70530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjimenezvega118741@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 1800",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 1800",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Griffin Christian Royale Jensen
• Patricia O Jensen, NP
• Michael Jenson
• Rachael Jerabek, OTD, OTR/L
• Hanah Jesz, MA, LMFT
• Abigail R Jing, DPT
• Karen Jiran-Salls, PT, PRC
• Mary Johannes
• James A Johanning, PA-C
• Justin Thomas Johnsen, PA-C

• Pediatric Endocrinology Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Pediatric Endocrinology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.