Individual provider Active NPI

Jessica Marie Skaare

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1861080376
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27510 Issued in MN
Practice address
3333 University Ave SE
Minneapolis, MN 55414-3325
Phone
(612) 767-7222
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27510 MN Primary

Addresses

Primary practice location

3333 University Ave SE
Minneapolis, MN 55414-3325

Mailing address

944 Ashland Ave Apt 9
Saint Paul, MN 55104-7021
Phone (507) 525-3582

Other practice location 1

560 Concordia Ave
Saint Paul, MN 55103-2443
Phone (612) 368-9278

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210428001752 MN Practitioner - Clinical Social Worker 7113335399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Jan 21, 2021 Accepting new patients
Fraser PastSince Jan 17, 2021 Accepting new patients

Locations

3333 University Ave SE
Minneapolis, MN 55414
Phone (612) 253-1139

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 2

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": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1861080376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 ASHLAND AVE APT 9",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551047021",
            "telephone_number": "507-525-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143325",
            "telephone_number": "612-767-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Concordia Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551032443",
            "country_code": "US",
            "telephone_number": "612-368-9278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKAARE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.