NPIMap

Individual provider Active NPI

Jon Scott Hallberg, M.D.

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1912931411
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36295 Issued in MN
Practice address
901 S 2ND St Ste a
University of Minnesota Physicians-Mill City Clinic
Minneapolis, MN 55415-2123
Phone
(612) 338-1383
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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 36295 MN Primary

Addresses

Primary practice location

901 S 2ND St Ste a
University of Minnesota Physicians-Mill City Clinic
Minneapolis, MN 55415-2123

Mailing address

420 Delaware St SE,
MMC 381 University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 624-2622

Other identifiers 6

IdentifierTypeStateIssuer
102652OtherMNUCARE
21741OtherMNARAZ
059A0HAOtherMNBCBS
1008966OtherMNPREFERRED ONE
955325800MedicaidMN
HP20043OtherMNHEALTHPARTNERS

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
I20101007000200 MN Practitioner - Family Practice 1456543602 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

516 Delaware St SE
Minneapolis, MN 55455-0356
Phone (612) 625-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
67.02
Promoting interoperability
99
Improvement activities
40
Cost
73.13

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Care System CurrentSince Mar 24, 2020 Accepting new patients
Fairview Health Services CurrentSince Mar 24, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 24, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Feb 12, 2001 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Mar 24, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Mar 24, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 24, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Feb 12, 2001 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast St. John'S Hospital CurrentSince Mar 24, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 24, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 30, 2020 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

420 Delaware St SE
#381
Minneapolis, MN 55455
Phone (612) 625-0646

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

901 S 2nd St
Ste A
Minneapolis, MN 55415
Phone (612) 273-6089

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

2615 E Franklin Ave
Minneapolis, MN 55406
Phone (612) 333-0770

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1414 Maryland Ave E
Saint Paul, MN 55106
Phone (651) 772-3461

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: jhallberg147999@fairview.direct-ci.com

Organizations & group practices 20

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 20

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1912931411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE,",
            "address_2": "MMC 381 UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-624-2622",
            "fax_number": "612-624-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 2ND ST STE A",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS-MILL CITY CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554152123",
            "telephone_number": "612-338-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLBERG",
        "first_name": "JON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "102652",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "21741",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "059A0HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1008966",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955325800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP20043",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.