Jacob Zimmerman

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1915 Lyndale Ave S
Minneapolis, MN 55403-3104

Phone

(800) 336-5973

Fax

(612) 234-4689

NPI assigned

Apr 20, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catalyst Mental Health, GBCGroup PAC ID 1355500752, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Catalyst Mental Health, GBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1134490147
  Medicare reassignment Care Compare group NPD
• Catalyst Mental Health, GBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Dora, FL
  • NPI 1639911167
  NPD

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1922452507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 5TH ST NE APT.1G",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033104",
            "telephone_number": "800-336-5973",
            "fax_number": "612-234-4689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 O'leary Ln.",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "55123",
            "country_code": "US",
            "telephone_number": "651-365-8224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE LPCC",
            "identifier": "1204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Zimmer, MA, CCC-SLP
• Kimberly Kay Zimmer
• Stephanie Zimmerman-Childress, 301385
• Andrea Nicole Zimmerman, PT
• Benjamin Jacob Zimmerman, DPT
• Jodie Ann Zimmerman, PHARMD
• John Zimmerman, CRNA
• Joshua Orr Zimmerman, MD
• Kristi Lea Zimmerman, D.C.
• Anna Marie Zimmermann, MD

• Professional Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.