NPIMap

Individual provider Active NPI

Jonathan R Ray

  • Family Medicine Physician
  • Plymouth, MN
National Provider Identifier
1619952389
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40421 Issued in MN
Practice address
3007 Harbor LN N
Park Nicollet Clinic Plymouth
Plymouth, MN 55447
Phone
(952) 993-8900
Fax
(952) 993-8955
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40421 MN Primary

Addresses

Primary practice location

3007 Harbor LN N
Park Nicollet Clinic Plymouth
Plymouth, MN 55447

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

4155 County Road 101 N
Plymouth, MN 55446-2307
Phone (952) 993-8900

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
I20100330001324 MN Practitioner - Family Practice 7719013630 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hutchinson HealthGroup PAC ID 0345330072, 145 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

1029 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4400

1071 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4610

1095 Hwy 15 S
Hutchinson, MN 55350-5000
Phone (320) 234-5000

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Hutchinson Health Hospital, Hutchinson, MN, CCN 240187
  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40421MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpartners RC CurrentSince Jan 8, 2025 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 1999 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Hutchinson Health CurrentSince Oct 1, 2024 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 1, 1999 Accepting new patients
Healthpartners RC CurrentSince Jan 8, 2025 Accepting new patients
Park Nicollet Methodist Hospital Past Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

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

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

100 Healthy Way
Olivia, MN 56277
Phone (320) 523-1261

4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000

3007 Harbor Ln N
Plymouth, MN 55447
Phone (612) 439-4650

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

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Interoperability endpoints

  • Direct secure messaging: jray23505@direct.healthpartners.com

Organizations & group practices 7

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 11

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1619952389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 HARBOR LN N",
            "address_2": "PARK NICOLLET CLINIC PLYMOUTH",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "952-993-8900",
            "fax_number": "952-993-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155 County Road 101 N",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554462307",
            "country_code": "US",
            "telephone_number": "952-993-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.