NPIMap

Individual provider Active NPI

Maura Clement Jacobi, MD

  • Family Medicine Physician
  • West Saint Paul, MN
National Provider Identifier
1962021162
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71440 Issued in MN
Practice address
234 Wentworth Ave E
West Saint Paul, MN 55118-3525
Phone
(651) 455-2940
Fax
(651) 455-3354
NPI assigned
Apr 9, 2020
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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 NU
Family Medicine Physician 207Q00000X 71440 MN Primary

Addresses

Primary practice location

234 Wentworth Ave E
West Saint Paul, MN 55118-3525

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Other names 1

  • Maura Elizabeth Clement Former name

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
I20230901000255 MN Practitioner - Family Practice 1052774429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

234 Wentworth Ave E
West St Paul, MN 55118-3525
Phone (651) 788-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71440MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast St. John's Hospital Past Accepting new patients
East Metro Family Practice, P.a. Family Medicine Past Accepting new patients

Locations

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

234 Wentworth Ave E
West St Paul, MN 55118
Phone (651) 455-2940

Interoperability endpoints

  • Direct secure messaging: maura.jacobi@entira.eclinicaldirectplus.com

Organizations & group practices 5

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 4

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1962021162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 WENTWORTH AVE E",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183525",
            "telephone_number": "651-455-2940",
            "fax_number": "651-455-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBI",
        "first_name": "MAURA",
        "middle_name": "CLEMENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "71440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURA",
            "last_name": "CLEMENT",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.