NPIMap

Individual provider Active NPI

Jacob Sundberg, M.D.

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1629456215
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61412 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101
Phone
(651) 254-3456
Fax
(651) 254-9673
NPI assigned
May 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61412 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (651) 254-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170216002758 MN Practitioner - Internal MedicinePractitioner - Hospitalist 1355646365 Reassigns benefits to 5 organizations
I20190618002809 WI Practitioner - Internal MedicinePractitioner - Hospitalist 1355646365 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthpartners RCGroup PAC ID 5890126726, shared by 7 NPIs, 52 clinicians
Hutchinson HealthGroup PAC ID 0345330072, 145 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians
Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians
Hudson Hospital IncGroup PAC ID 0648183061, 37 clinicians
Westfields Hospital IncGroup PAC ID 2264490960, 108 clinicians

Practice addresses (Care Compare)

100 Healthy Way
Olivia, MN 56277-1117
Phone (320) 523-1460

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

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

1500 Curve Crest W Blvd
Stillwater, MN 55082-6040
Phone (651) 439-1234

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000

411 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westfields Hospital, Inc. CurrentSince Apr 29, 2022 Accepting new patients
Westfields Hospital, Inc CurrentSince Apr 29, 2022 Accepting new patients
Group Health, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Hutchinson Health CurrentSince Jun 1, 2019 Accepting new patients
Hudson Hospital, Inc. CurrentSince May 14, 2019 Accepting new patients
Fairview Health Services CurrentSince Feb 28, 2017 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Health Services Internal Medicine CurrentSince Feb 28, 2017 Accepting new patients
St. Croix Regional Medical Center CurrentSince May 11, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 31, 2025 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Nov 4, 2020 Accepting new patients
Hudson Hospital, Inc. CurrentSince May 14, 2019 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Nov 4, 2020 Accepting new patients
Group Health, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Healthpartners RC CurrentSince Sep 1, 2022 Accepting new patients
Healthpartners RC CurrentSince Sep 1, 2022 Accepting new patients
St. Croix Regional Medical Center CurrentSince May 11, 2019 Accepting new patients
Regions 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

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

1500 Curve Crest Blvd W
Stillwater, MN 55082

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1629456215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDBERG",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "61412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.