NPIMap

Individual provider Active NPI

Jacob R Oestreich, MD

  • Family Medicine Physician
  • Duluth, MN
National Provider Identifier
1700854262
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47744 Issued in MN
Practice address
4325 Grand Ave
Duluth, MN 55807-2730
Phone
(218) 722-1497
Fax
(218) 722-6239
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50883 WI
Family Medicine Physician 207Q00000X 47744 MN Primary

Addresses

Primary practice location

4325 Grand Ave
Duluth, MN 55807-2730

Mailing address

2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 392-1955

Other practice location 1

2222 E 5th St
Superior, WI 54880-3709
Phone (715) 392-1955

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
I20050908000080 MN Practitioner - Family Practice 6709818016 Reassigns benefits to 1 organization
I20110211001001 WI Practitioner - Family Practice 6709818016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Superior Community Health CenterGroup PAC ID 6608810031, 11 clinicians

Practice addresses (Care Compare)

2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 392-1955

4325 Grand Ave
Duluth, MN 55807-2730
Phone (218) 722-1497

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Duluth, MN, CCN 247029
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50883WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Superior Community Health Center Current Accepting new patients

Locations

4325 Grand Ave
Duluth, MN 55807
Phone (218) 628-7035

3600 Tower Ave
Superior, WI 54880
Phone (715) 392-1955

2222 E 5th St
Superior, WI 54880
Phone (715) 392-1955

1500 N 34th St
Ste 200
Superior, WI 54880
Phone (715) 392-8216

Interoperability endpoints

  • Direct secure messaging: joestreich814029@direct.ochin.org

Organizations & group practices 2

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1700854262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803709",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072730",
            "telephone_number": "218-722-1497",
            "fax_number": "218-722-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548803709",
            "country_code": "US",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OESTREICH",
        "first_name": "JACOB",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50883",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.