Individual provider Active NPI

Jaskanwal Deep Singh Sara, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1710417779
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
65927 Issued in MN
Practice address
225 Smith Ave N Ste 400
Saint Paul, MN 55102-2568
Phone
(651) 290-0133
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 65927 MN
Internal Medicine Physician 207R00000X 65927 MN Primary

Addresses

Primary practice location

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

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jsara632780@excellian.direct.allina.com Direct
Direct Messaging Address jsara140384@ehrdirect.mayoclinicmsg.org

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
I20190822003673 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426321779 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65927MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Mayo Clinic CurrentSince Jul 16, 2019 Accepting new patients
Mayo Clinic CurrentSince Jul 16, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Mayo Clinic 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

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

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

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

Interoperability endpoints

  • Direct secure messaging: jsara784346@fairview.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1710417779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-4258"
        },
        {
            "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": "SARA",
        "first_name": "JASKANWAL DEEP",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "65927",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "65927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsara632780@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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsara140384@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "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.