NPIMap

Individual provider Active NPI

Jill Lesly Baldwin, PA-C

  • Physician Assistant
  • Fergus Falls, MN
National Provider Identifier
1720038029
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11089 Issued in MN
Practice address
712 S Cascade St
Fergus Falls, MN 56537-2913
Phone
(701) 538-4839
NPI assigned
May 10, 2006
Last updated
Apr 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11089 MN Primary
Physician Assistant 363A00000X PAC0203 ND

Addresses

Primary practice location

712 S Cascade St
Fergus Falls, MN 56537-2913

Mailing address

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (701) 538-4839

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbaldwin14322294@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 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
I20120718000585 MN Practitioner - Physician Assistant 5193981256 Reassigns benefits to 1 organization
I20200219001176 ND Practitioner - Physician Assistant 5193981256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

21 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone (701) 538-4189

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11089MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince May 1, 2012 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 18, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 18, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Apr 13, 2024 Accepting new patients

Locations

712 S Cascade St
Fergus Falls, MN 56537

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Interoperability endpoints

  • Direct secure messaging: jbaldwin14322294@direct.sanfordhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1720038029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "701-538-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "701-538-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "JILL",
        "middle_name": "LESLY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11089",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbaldwin14322294@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "712 S Cascade St",
            "city": "Fergus Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565372913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.