NPIMap

Individual provider Active NPI

Jonathan Ross Dickman, M.D., PHD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1891037289
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58327 Issued in MN
Practice address
233 Grand Ave
Saint Paul, MN 55102-2331
Phone
(651) 241-5200
Fax
(651) 241-6427
NPI assigned
Mar 23, 2013
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58327 MN Primary

Addresses

Primary practice location

233 Grand Ave
Saint Paul, MN 55102-2331

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

Other practice location 2

345 Smith Ave N
Saint Paul, MN 55102-2346
Phone (651) 220-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdickman206201@excellian.direct.allina.com Direct

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
I20150108000019 MN Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 8325361843 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58327MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
NPI 1457657256 CurrentSince Dec 31, 2022 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Nov 3, 2017 Accepting new patients
Allina Health System CurrentSince Jan 11, 2021 Accepting new patients
Allina Health System CurrentSince Jan 11, 2021 Accepting new patients
NPI 1083910871 Family Medicine Past Accepting new patients
Allina Health System Family Medicine PastSince Dec 1, 2020 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

233 Grand Ave
Saint Paul, MN 55102
Phone (651) 241-1001

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

333 Smith Ave N
Ste 4640
Saint Paul, MN 55102
Phone (651) 241-1001

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

Interoperability endpoints

  • Direct secure messaging: jdickman206201@excellian.direct.allina.com

Organizations & group practices 9

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.

Hospital & facility affiliations 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1891037289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022331",
            "telephone_number": "651-241-5200",
            "fax_number": "651-241-6427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Smith Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022344",
            "country_code": "US",
            "telephone_number": "651-241-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Smith Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022346",
            "country_code": "US",
            "telephone_number": "651-220-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "JONATHAN",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-23",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdickman206201@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "333 Smith Ave N Ste 4640",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551022344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.