Individual provider Active NPI

Jason M Robertson, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1972575256
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41329 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(123) 123-1234
Fax
(651) 254-3662
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41329 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8100 34TH Ave S
Mc21110Q
Bloomington, MN 55425-1672
Phone (123) 123-1234

Other practice location 1

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3230

Other identifiers 1

IdentifierTypeStateIssuer
071617100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100603000884 MN Practitioner - Internal MedicinePractitioner - Hospitalist 7416086285 Reassigns benefits to 2 organizations
I20170501000706 WI Practitioner - Hospitalist 7416086285 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Medical College of Wisconsin, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

927 Churchill W St
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41329MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amery Regional Medical Center, Inc. CurrentSince Mar 28, 2017 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2020 Accepting new patients
Group Health, Inc. CurrentSince Aug 28, 2000 Accepting new patients
Group Health, Inc. CurrentSince Aug 28, 2000 Accepting new patients
Westfields Hospital, Inc CurrentSince Mar 28, 2017 Accepting new patients
Hudson Hospital, Inc. CurrentSince Mar 28, 2017 Accepting new patients
Hudson Hospital, Inc. CurrentSince Mar 28, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Mar 28, 2017 Accepting new patients
Westfields Hospital, Inc. CurrentSince Mar 28, 2017 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2020 Accepting new patients
Lakeview Memorial Hospital Association Inc Past Accepting new patients
Regions Hospital Past Accepting new patients

Locations

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

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

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
West Lakeland, MN 55082

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

411 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

Organizations & group practices 14

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 14

Hospital & facility affiliations 10

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1972575256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "MC21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "123-123-1234",
            "fax_number": "651-254-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "123-123-1234",
            "fax_number": "651-254-3662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-993-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "41329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071617100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.