NPIMap

Individual provider Active NPI

Jean B Watson, MD

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1710949656
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41763 Issued in MN
Practice address
800 E 28TH St
250
Minneapolis, MN 55407-3723
Phone
(612) 863-5665
Fax
(612) 863-4144
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41763 MN Primary

Addresses

Primary practice location

800 E 28TH St
250
Minneapolis, MN 55407-3723

Mailing address

3433 Broadway St NE
Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

Other identifiers 1

IdentifierTypeStateIssuer
128436300MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwatson86527@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108000154 MN Practitioner - Internal Medicine 1254359367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

800 E 28TH St
Minneapolis, MN 55407-3723

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41763MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Sep 1, 2001 Accepting new patients
Allina Health System CurrentSince Sep 1, 2001 Accepting new patients
Allina Health System Past Accepting new patients

Locations

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

800 E 28th St
#250
Minneapolis, MN 55407
Phone (612) 863-5665

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

Interoperability endpoints

  • Direct secure messaging: jwatson86527@excellian.direct.allina.com

Organizations & group practices 4

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1710949656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE",
            "address_2": "STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "763-587-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "address_2": "250",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-5665",
            "fax_number": "612-863-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JEAN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "41763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128436300",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwatson86527@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St",
            "address_2": "250",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.