NPIMap

Individual provider Active NPI

Jessica L Mahoney, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1659836070
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
6426 Issued in MN
Practice address
225 Smith Ave N Ste 400
Saint Paul, MN 55102-2568
Phone
(651) 290-0133
NPI assigned
Feb 11, 2019
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG02190059 MN
Adult Health Nurse Practitioner 363LA2200X 6426 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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmahoney22582@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
I20190417001206 MN Practitioner - Nurse Practitioner 1557602752

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

225 N Smith Ave
Suite 400
St Paul, MN 55102-2568

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6426MNMDPhysical Therapist
AG02190059MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: jmahoney22582@excellian.direct.allina.com

Organizations & group practices 1

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.

  • Allina Health System

    dba Allina Health Buffalo Specialty Clinic

    • Obstetrics & Gynecology Physician
    • Buffalo, MN
    • NPI 1295272342
    NPD

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1659836070",
    "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "AG02190059",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "6426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmahoney22582@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.