Jill Katherine Wieser, MD
Individual provider Active NPI Dermatology Physician · Maple Grove, MN
NPI 1902398779 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1902398779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 76583 (MN)
- Practice address
- 7840 Vinewood LN N
Maple Grove, MN 55369-7185 - Phone
- (763) 236-0200
- NPI assigned
- Jun 6, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of North Dakota School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allina Health System
Practice addresses (Care Compare)
500 Osborne Rd NE
Suite 150
Fridley, MN 55432-2770
Phone (763) 236-2500
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 35 |
| Removal of skin lesions | 263 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 111 |
| Skin biopsy | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240725001222 | MN | Practitioner - Dermatology | 7618221870 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PEND | OH | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
7840 Vinewood Ln N
Maple Grove, MN 55369
Phone (763) 236-0200
9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155
500 Osborne Rd NE
Ste 150
Minneapolis, MN 55432
Phone (763) 236-2500
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
Interoperability endpoints
- jwieser670130@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | PEND | OH | |
| Dermatology Physician | 207N00000X | 76583 | MN | Yes |
Addresses
Primary practice location
7840 Vinewood LN N
Maple Grove, MN 55369-7185
Mailing address
7840 Vinewood LN N
Maple Grove, MN 55369-7185
Other practice location 1
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-8200
Other practice location 2
500 Osborne Rd NE Ste 150
Fridley, MN 55432-2770
Phone (763) 236-2500
Other providers in Maple Grove, MN
- Daniel Lee Whited
- Ryan Wicht
- Brittany Wiczek
- Lisa Widder
- James Wiencke
- Sarah Elisabeth Wiger
- Jeannette Louise Wilcox
- Leslie Lorraine Wilcox
- Wild Roots Counseling LLC
- Hannah Willford
All providers in Maple Grove, MN · Dermatology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.