NPIMap

Individual provider Active NPI

Jay Joseph Allen, M.D.

  • Family Medicine Physician
  • Duluth, MN
National Provider Identifier
1891228094
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66743 Issued in MN
Practice address
1502 London Rd Ste 102
Duluth, MN 55812-1787
Phone
(218) 576-0100
NPI assigned
Apr 5, 2017
Last updated
Jul 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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
Family Medicine Physician 207Q00000X 66743 MN Primary

Addresses

Primary practice location

1502 London Rd Ste 102
Duluth, MN 55812-1787

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

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
I20200629003513 MN Practitioner - Family PracticePractitioner - Emergency Medicine 7810319340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Duluth Graduate Medical Education Council IncGroup PAC ID 4385545953, 32 clinicians

Practice addresses (Care Compare)

1502 London Rd
Suite 102
Duluth, MN 55812-1787
Phone (218) 727-8228

1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 17, 2020 Accepting new patients
The Duluth Clinic, LTD CurrentSince Aug 17, 2020 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 1, 2020 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 1, 2020 Accepting new patients
Redwood Area Hospital Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Duluth Graduate Medical Education Council Inc Family Medicine CurrentSince Jun 18, 2021 Accepting new patients
Essentia Health Virginia LLC Past Accepting new patients

Locations

1502 London Rd
Ste 102
Duluth, MN 55812
Phone (218) 576-0100

330 N 8th Ave E
Duluth, MN 55805
Phone (218) 529-9122

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

101 Caring Way
Redwood Falls, MN 56283
Phone (507) 637-2911

Organizations & group practices 11

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 2

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1891228094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LONDON RD STE 102",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121787",
            "telephone_number": "218-576-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JAY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "66743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.