Jessica Simmons Sjoholm, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

66335 Issued in MN

Practice address

4194 Lexington Ave N
Shoreview, MN 55126-6106

Phone

(516) 483-5461

Fax

(516) 483-2155

NPI assigned

Apr 1, 2017

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

University of Minnesota Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Urgent Care Shoreview

  • Urgent Care Clinic/Center
  • Shoreview, MN
  • NPI 1841806767
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Allina Health System

  dba Allina Health Orthopedic, Podiatry and Spine Clinic-Faribault

  • Orthopaedic Surgery Physician
  • Faribault, MN
  • NPI 1972006807
  NPD
• Allina Health System

  dba Allina Health Inver Grove Heights Clinic

  • Family Medicine Physician
  • Inver Grove Heights, MN
  • NPI 1083910871
  NPD (past)

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1710419395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4194 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551266106",
            "telephone_number": "516-483-5461",
            "fax_number": "651-483-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4194 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551266106",
            "telephone_number": "516-483-5461",
            "fax_number": "516-483-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJOHOLM",
        "first_name": "JESSICA",
        "middle_name": "SIMMONS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-01",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "66335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Ann Shuck, MSW, LGSW
• Nathanael Paul Shull
• Angela Siegle, LPC
• Michael Simons, HID
• Natalie Sinkler, MSW, LICSW
• Smisek Family Dentistry P.a.
• Gary Ralph Smisek, D.D.S.
• Ronald Miichael Smisek, DDS
• Donna Jean Smith, LMFT
• Jamie Smuder, PHARMD

• Internal Medicine Physician in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.