NPIMap

Individual provider Active NPI

Jason Yungil Ryu

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1629847199
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14801 Issued in MN
Practice address
225 Smith Ave N Ste 400
Saint Paul, MN 55102-2568
Phone
(651) 290-0133
Fax
(651) 241-2910
NPI assigned
Dec 26, 2023
Last updated
Mar 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14801 MN Primary

Addresses

Primary practice location

225 Smith Ave N Ste 400
Saint Paul, MN 55102-2568

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jryu699287@excellian.direct.allina.com Direct

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
I20240216000128 MN Practitioner - Physician Assistant 8022452184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

800 E 28TH St
Minneapolis, MN 55407-3723

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Feb 1, 2024 Accepting new patients
Allina Health System CurrentSince Feb 24, 2025 Accepting new patients
Mayo Clinic CurrentSince Feb 1, 2024 Accepting new patients
Allina Health System CurrentSince Feb 24, 2025 Accepting new patients
NPI 1083910871 Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

225 Smith Ave N
Ste 400
Saint Paul, MN 55102
Phone (651) 290-0133

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1629847199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N STE 400",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022568",
            "telephone_number": "651-290-0133",
            "fax_number": "651-241-2910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYU",
        "first_name": "JASON",
        "middle_name": "YUNGIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-26",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jryu699287@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "225 Smith Ave N Ste 400",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551022568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.