Individual provider Active NPI

Charles Frederick Jaschek, MD

  • Psychiatry Physician
  • Minneapolis, MN
National Provider Identifier
1720617244
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
79602 Issued in MN
Practice address
2312 S 6TH St FL 2
Minneapolis, MN 55454
Phone
(612) 625-3330
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76588 WI
Child & Adolescent Psychiatry Physician 2084P0804X 76588 WI
Child & Adolescent Psychiatry Physician 2084P0804X 2023019837 MO
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 79602 MN Primary

Addresses

Primary practice location

2312 S 6TH St FL 2
Minneapolis, MN 55454

Mailing address

2312 S 6TH St FL 2
Minneapolis, MN 55454-1336

Other practice location 1

4444 Forest Park Ave Ste 2600
Saint Louis, MO 63108-2212
Phone (314) 286-1700

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
I20250520000204 MN Practitioner - Psychiatry 4880017631 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76588WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince May 13, 2025 Accepting new patients
Fairview Express Care CurrentSince May 13, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince May 13, 2025 Accepting new patients
Fairview Express Care CurrentSince May 13, 2025 Accepting new patients

Locations

2025 E River Rd
Minneapolis, MN 55414
Phone (612) 301-0115

2312 S 6th St
Fl 2
Minneapolis, MN 55454
Phone (612) 273-8700

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1720617244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 S 6TH ST FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 S 6TH ST FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-625-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4444 Forest Park Ave Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631082212",
            "country_code": "US",
            "telephone_number": "314-286-1700",
            "fax_number": "314-747-6777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASCHEK",
        "first_name": "CHARLES",
        "middle_name": "FREDERICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "76588",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "76588",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2023019837",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "79602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.