Active NPI
Jason M Robertson, MD
- Internal Medicine Physician
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 41329
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071617100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Medical College of Wisconsin, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Regions Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41329 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc | Current | Accepting new patients | |
| Hudson Hospital, Inc. | Current | Accepting new patients | |
| Hudson Hospital, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc. | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | 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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
- Critical Access Hospital
- Hudson, WI
- NPI 1396849303
-
- Critical Access Hospital
- New Richmond, WI
- NPI 1881640183
-
- Family Medicine Physician
- Stillwater, MN
- NPI 1578932943
-
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1912315144
-
- Rural Health Clinic/Center
- Luck, WI
- NPI 1851345268
-
- Critical Access Hospital
- Hudson, WI
- NPI 1255532875
-
- Hematology & Oncology Physician
- Osceola, WI
- NPI 1477228070
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1538138003
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1306873872
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1629006457
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1679391122
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1962149419
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.