NPIMap

Individual provider Active NPI

Jacob P. Hayman, MD

  • Family Medicine Physician
  • Minnetonka, MN
National Provider Identifier
1720252299
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50849 Issued in MN
Practice address
15111 Twelve Oaks Center Dr
Carlson Clinic
Minnetonka, MN 55305-5201
Phone
(952) 993-4500
NPI assigned
Apr 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 50849 MN
Family Medicine Physician 207Q00000X 50849 MN Primary

Addresses

Primary practice location

15111 Twelve Oaks Center Dr
Carlson Clinic
Minnetonka, MN 55305-5201

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

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
I20090514000370 MN Practitioner - Sports MedicinePractitioner - Family Practice 2961551312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Wright State University Boonshoft School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

15111 Twelve Oaks Ctr Dr
Minnetonka, MN 55305-5201
Phone (952) 993-4500

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Care SVCS Home health agency, Minneapolis, MN, CCN 247151
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50849MNMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 8, 2011 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Sep 8, 2011 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Mar 17, 2012 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

15111 Twelve Oaks Center Dr
Minnetonka, MN 55305
Phone (952) 993-4500

Interoperability endpoints

  • Direct secure messaging: jhayman156780@direct.healthpartners.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 7

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1720252299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 TWELVE OAKS CENTER DR",
            "address_2": "CARLSON CLINIC",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055201",
            "telephone_number": "952-993-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYMAN",
        "first_name": "JACOB",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "50849",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.