Individual provider Active NPI

Jaena J Wisniewski, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Maplewood, MN
National Provider Identifier
1710032594
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
52638 Issued in MN
Practice address
2945 Hazelwood St Ste 310
Maplewood, MN 55109-1244
Phone
(651) 264-1500
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 68895-20 WI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 52638 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 310
Maplewood, MN 55109-1244

Mailing address

2945 Hazelwood St Ste 310
Maplewood, MN 55109-1244
Phone (651) 264-1500

Other practice location 1

1650 4th St SE
Rochester, MN 55904-4717
Phone (507) 529-6600

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000184 MN Practitioner - Pathology 4385779727 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Michigan State University College of Human Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians
Central Regional Pathology Laboratories PAGroup PAC ID 1658356696, 6 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (763) 525-1746

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2945 Hazelwood St
Suite 310
Maplewood, MN 55109-1244
Phone (651) 264-1500

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Western Wisconsin Health Hospital, Baldwin, WI, CCN 521347
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52638MNMDAnatomic Pathology & Clinical Pathology Physician
68895-20WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast St. John'S Hospital CurrentSince Jun 11, 2021 Accepting new patients
Olmsted Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jun 11, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 11, 2021 Accepting new patients
Olmsted Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients
Fairview Health Services CurrentSince Mar 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients
Fairview Health Services Clinical Pathology/Laboratory Medicine CurrentSince Mar 1, 2022 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Care System CurrentSince Jun 11, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 11, 2021 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2022 Accepting new patients
Fairview Bethesda Hospital CurrentSince Jun 11, 2021 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

14101 Fairview Dr
Ste 200
Burnsville, MN 55337
Phone (952) 405-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

210 9th St SE
Rochester, MN 55904
Phone (507) 529-6616

1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

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 8

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1710032594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 310",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091244",
            "telephone_number": "651-264-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 310",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091244",
            "telephone_number": "651-264-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 4th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559044717",
            "country_code": "US",
            "telephone_number": "507-529-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "JAENA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "68895-20",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "52638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.