Active NPI
Michael Jenson
- Physician Assistant
- Woodbury, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12473
- Practice address
- 6025 Lake Rd Ste 200
Woodbury, MN 55125-1710 - Phone
- (651) 999-6800
- Fax
- (833) 905-0989
- NPI assigned
- Apr 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12473 | MN | Primary |
Addresses
Primary practice location
6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Mailing address
6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone (651) 999-6800
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1185 Town Centre Dr
Eagan, MN 55123-1189
Phone (651) 999-6800
3960 Coon Rapids Blvd NW
Suite 301
Coon Rapids, MN 55433-2598
Phone (651) 999-6800
500 Osborne Rd NE
Suite 120
Fridley, MN 55432-2767
Phone (651) 999-6800
6025 Lake Rd
Suite 200
Woodbury, MN 55125-1710
Phone (651) 999-6800
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.84 of 100
- Quality
- 64.59
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 84.88
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12473 | MN | MD | Family Nurse Practitioner |
Interoperability endpoints
- michael.jenson.1@20581.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Urology Physician
- Woodbury, MN
- NPI 1912971912
Hospital & facility affiliations 17
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1457319485
-
- General Acute Care Hospital
- Hastings, MN
- NPI 1508457045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1841724291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6025 LAKE RD STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251710",
"telephone_number": "651-999-6800",
"fax_number": "651-999-6970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6025 LAKE RD STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251710",
"telephone_number": "651-999-6800",
"fax_number": "833-905-0989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSON",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-12",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.