Individual provider Active NPI

Richard Jennis, MD

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1891777975
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
150610 Issued in MA
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 150610 MA Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Other practice location 1

795 Middle St
Fall River, MA 02721-1733
Phone (508) 996-3991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI, TX, MI, OH, WV6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20051216000216 MA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9739100801 Reassigns benefits to 2 organizations
I20120510000250 RI Practitioner - Diagnostic Radiology 9739100801 Reassigns benefits to 8 organizations
I20211222000305 TX Practitioner - Diagnostic Radiology 9739100801 Reassigns benefits to 4 organizations
I20220324001143 MI Practitioner - Diagnostic Radiology 9739100801 Reassigns benefits to 1 organization
I20260312002319 OH Practitioner - Diagnostic Radiology 9739100801 Reassigns benefits to 1 organization
I20260508000017 WV Practitioner - Diagnostic Radiology 9739100801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Regional Healthcare IncGroup PAC ID 0840107835, 301 clinicians
Arh Tug Valley Health Services, Inc.Group PAC ID 4183953805, 108 clinicians
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians
Angelina Diagnostic Radiology AssociatesGroup PAC ID 1850380890, 71 clinicians
WRH Physicians, IncGroup PAC ID 0840342366, 149 clinicians
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians
Virtual Radiologic Professionals LLCGroup PAC ID 4981608817, 392 clinicians
Boone Memorial Hospital IncGroup PAC ID 3375433352, shared by 8 NPIs, 78 clinicians

Practice addresses (Care Compare)

Providence, RI 02906
Phone (606) 439-1331

1705 Jackson St
Richmond, TX 77469-3246
Phone (479) 452-9416

1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone (330) 971-7246

41 Boylston Ave
Providence, RI 02906-2412
Phone (832) 915-2534

701 Madison Ave
Madison, WV 25130-1669
Phone (304) 369-1230

Hospital & facility affiliations

  • Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
  • Holy Family Hospital Hospital, Methuen, MA, CCN 220080
  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Central Vermont Medical Center Hospital, Barre, VT, CCN 470001
  • Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ton San Xavier Health Center CurrentSince Dec 1, 2021 Accepting new patients
WRH Physicians, Inc. CurrentSince Feb 20, 2026 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 30, 2015 Accepting new patients
Specialists in Medical Imaging, SC Diagnostic Radiology CurrentSince Jul 6, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 1, 2019 Accepting new patients
Lifespan of Massachusetts - Taunton Inc CurrentSince Jul 24, 2025 Accepting new patients
Lifespan of Massachusetts - Taunton Inc CurrentSince Jul 28, 2025 Accepting new patients
Ascension Borgess Lee Hospital Current Accepting new patients
Ton Sells Hospital CurrentSince Dec 1, 2021 Accepting new patients
Ton San Simon Health Center CurrentSince Dec 1, 2021 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Jan 1, 2021 Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Dec 7, 2021 Accepting new patients
T J Samson Community Hospital CurrentSince Feb 1, 2026 Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

901 Grant St
Harvard, IL 60033
Phone (815) 943-5431

3922 Mercy Dr
McHenry, IL 60050
Phone (815) 344-4499

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

2000 Lake Ave
Woodstock, IL 60098
Phone (815) 337-4116

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

3033 State Rd
Ste 101
Cuyahoga Fls, OH 44223
Phone (330) 923-8372

1900 23rd St
Cuyahoga Fls, OH 44223
Phone (330) 929-2685

Interoperability endpoints

  • Direct secure messaging: rjennis46691@tuftsmedicine.direct-ci.com

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 5

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1891777975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Middle St",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027211733",
            "country_code": "US",
            "telephone_number": "508-996-3991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNIS",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "150610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.