Individual provider Active NPI

Jane Baillargeon, PSY D, LP

  • Psychologist
  • Woodbury, MN
National Provider Identifier
1972013894
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP6161 Issued in MN
Practice address
8425 Seasons Pkwy Ste 105
Woodbury, MN 55125-4393
Phone
(952) 993-6200
NPI assigned
Oct 5, 2017
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP6161 MN Primary
Clinical Psychologist 103TC0700X LP6161 MN

Addresses

Primary practice location

8425 Seasons Pkwy Ste 105
Woodbury, MN 55125-4393

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

1002 148th St
Amery, WI 54001-4845
Phone (651) 295-8567

Other practice location 2

1600 University Ave W Ste 12
Saint Paul, MN 55104-3898
Phone (651) 379-5157

Other practice location 3

1540 Lake St S
Forest Lake, MN 55025-2628
Phone (651) 464-7100

Other names 1

  • Jane E Hawley Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171214002561 MN Practitioner - Clinical Psychologist 9739447079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

3525 Monterey Dr
St Louis Park, MN 55416-5275
Phone (952) 993-1990

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8425 Seasons Pkwy
Suite 105
Woodbury, MN 55125-4393
Phone (952) 993-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP6161MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Sep 30, 2024 Accepting new patients
Allina Health System CurrentSince Jul 7, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince Sep 30, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Allina Health System CurrentSince Jul 7, 2023 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1540 Lake St S
Forest Lake, MN 55025
Phone (651) 464-7100

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

2550 University Ave W
Ste 314N
Saint Paul, MN 55114
Phone (651) 330-3931

8425 Seasons Pkwy
Ste 105
Woodbury, MN 55125
Phone (952) 993-7672

Organizations & group practices 6

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 6

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": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1972013894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "fax_number": "651-379-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 SEASONS PKWY STE 105",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254393",
            "telephone_number": "952-993-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 148th St",
            "address_purpose": "LOCATION",
            "city": "Amery",
            "state": "WI",
            "postal_code": "540014845",
            "country_code": "US",
            "telephone_number": "651-295-8567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 University Ave W Ste 12",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043898",
            "country_code": "US",
            "telephone_number": "651-379-5157",
            "fax_number": "651-379-5159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Lake St S",
            "address_purpose": "LOCATION",
            "city": "Forest Lake",
            "state": "MN",
            "postal_code": "550252628",
            "country_code": "US",
            "telephone_number": "651-464-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILLARGEON",
        "first_name": "JANE",
        "credential": "PSY D, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6161",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "HAWLEY",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.