Susan M Jagodzinski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9714 Issued in MN

Practice address

1013 Hart Blvd
Monticello, MN 55362-8575

Phone

(763) 271-2248

Fax

(763) 271-2890

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjagodzinski22851@direct.centracare.com

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.

• Emergency Physicians Professional Association

  dba Emergency Physicians, P.A.

  • Emergency Medicine Physician
  • Bloomington, MN
  • NPI 1801871934
  Medicare reassignment
• Emergency Physicians Professional Association

  dba The Urgency Room - Golden Valley

  • Urgent Care Clinic/Center
  • Golden Valley, MN
  • NPI 1750188488
  NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1982664769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10749 KILBURY AVE SW",
            "city": "HOWARD LAKE",
            "state": "MN",
            "postal_code": "553495519",
            "telephone_number": "320-543-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "763-271-2248",
            "fax_number": "763-271-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODZINSKI",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R101747-4",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "9714",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388243800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Lydia Ibarra
• IHS Midwest PC
• Independent School District 882 (Monticello Public Schools)
• Integrated Care Clinics, PA (Great River Spine & Sport)
• J & L Enterprise LLC
• Geraldine Sorelly Jaramillo
• JD Outdoor Services LLC
• Julia Jean Jerome
• Jenifer Elizabeth John, MA LMFT LICSW
• Brent Johnson, DPT

• Physician Assistant in Monticello, MN
• Providers in Monticello, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.