NPIMap

Individual provider Active NPI

Jacob Dubay, D.O.

  • Obstetrics & Gynecology Physician
  • Sartell, MN
National Provider Identifier
1831514686
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
66318 Issued in MN
Practice address
2251 Connecticut Ave S
Sartell, MN 56377
Phone
(320) 253-5220
Fax
(320) 203-2200
NPI assigned
Mar 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA
Obstetrics & Gynecology Physician 207V00000X 66318 MN Primary

Addresses

Primary practice location

2251 Connecticut Ave S
Sartell, MN 56377

Mailing address

8170 33Rd Ave S
Mail Stop 21110Q
Bloomington, MN 55425-4516
Phone (320) 253-5220

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
I20180806002971 MN Practitioner - Obstetrics/Gynecology 2769758895 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone (320) 229-4917

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Centracare Health System - Melrose Hospital Hospital, Melrose, MN, CCN 241330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66318MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System - Melrose CurrentSince Mar 1, 2022 Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2020 Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2020 Accepting new patients
Centracare Health System-NR LLC CurrentSince May 1, 2022 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Apr 1, 2022 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Apr 1, 2022 Accepting new patients
Centracare Health System-NR LLC CurrentSince May 1, 2022 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System - Melrose CurrentSince Mar 1, 2022 Accepting new patients
St. Cloud Hospital Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Ste 2300
Saint Cloud, MN 56303
Phone (320) 654-3630

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

Interoperability endpoints

  • Direct secure messaging: jdubay413033@direct.centracare.com

Organizations & group practices 12

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 8

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": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1831514686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MAIL STOP 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBAY",
        "first_name": "JACOB",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-03",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "66318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.