NPIMap

Individual provider Active NPI

Jason Wiederin, MD

  • Hospitalist Physician
  • Duluth, MN
National Provider Identifier
1669979597
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
69087 Issued in MN
Practice address
420 E 1St St
Duluth, MN 55805-1901
Phone
(182) 786-6454
NPI assigned
Apr 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 69087 MN
Hospitalist Physician 208M00000X 69087 MN Primary

Addresses

Primary practice location

420 E 1St St
Duluth, MN 55805-1901

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

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
I20210922003577 MN Practitioner - Internal Medicine 1759632672 Reassigns benefits to 1 organization
I20230628000905 WI Practitioner - Geriatric MedicinePractitioner - Hospitalist 1759632672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 392-8281

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • St Marys Hospital Superior Hospital, Superior, WI, CCN 521329
  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • Twin Ports Health Services Nursing home, Superior, WI, CCN 525370
  • Middle River Health and Rehabilitation Center Nursing home, South Range, WI, CCN 525408

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69087MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Sep 27, 2021 Accepting new patients
St. Mary'S Duluth Clinic Health System Current Accepting new patients
St. Mary'S Hospital of Superior Current Accepting new patients
The Duluth Clinic LTD CurrentSince Sep 27, 2021 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St. Mary'S Hospital of Superior CurrentSince May 14, 2023 Accepting new patients
Middle River Rehabilitation LLC PastSince Apr 16, 2024 Accepting new patients
NSH Superior LLC PastSince Jul 1, 2023 Accepting new patients
St Marys Medical Center Past Accepting new patients

Locations

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Twin Ports Health ServicesSuperior, WI, CCN 525370 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2023
Jul 1, 2023
Middle River Health and Rehabilitation CenterSouth Range, WI, CCN 525408 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 16, 2024
Apr 16, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 6

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": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1669979597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051901",
            "telephone_number": "182-786-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERIN",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "69087",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "69087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.