Jake Michael Traxler, MD
Individual provider Active NPI Family Medicine Physician · Glencoe, MN
NPI 1780171413 · NPPES record last updated Apr 14, 2022
Key facts
- NPI
- 1780171413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 65946 (MN)
- Practice address
- 1805 Hennepin Ave N
Glencoe, MN 55336-1416 - Phone
- (320) 864-3121
- NPI assigned
- Apr 18, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Creighton University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Glencoe Regional Health Services
Practice addresses (Care Compare)
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121
1805 N Hennepin Ave
Glencoe, MN 55336-1416
Hospital & facility affiliations
- Allina Health Home Health
- Ridgeview Home Care Services
- Ecumen Home Care and Hospice - Litchfield
- Adara Home Health Inc
- Glencoe Regional Health
- Hutchinson Health
- Glenfields Living With Care
- Glencoe Regional Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210922000029 | MN | Practitioner - Family Practice | 5597199448 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65946 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glencoe Regional Health Services | Current |
Accepting new patients | |
| Glencoe Regional Health Services | Current |
Accepting new patients | |
| Glencoe Regional Health Services | Past | Accepting new patients |
Locations
1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121
300 Bowman St
Stewart, MN 55385
Phone (320) 562-2558
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 65946 | MN | Yes |
Addresses
Primary practice location
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Mailing address
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jtraxler562935@excellian.direct.allina.com | Direct |
Other providers in Glencoe, MN
- The Jonas Center
- Joslin Dawn Thiemann
- Lisa M Thompson
- Aubree Thorseth
- Touch of Gray Adult Day Center, LLC
- April Jo Trebelhorn
- Sheri Solseng Trif
- Skyler Vander Vorst
- Rachel L Villnow
- Douglas Lee Wagoner
All providers in Glencoe, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.