NPIMap

Individual provider Active NPI

Jeremy William Cook, M.D

  • Dermatology Physician
  • Woodbury, MN
National Provider Identifier
1982865317
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
52654 Issued in MN
Practice address
587 Bielenberg Dr
Suite 200
Woodbury, MN 55125-4451
Phone
(651) 578-2700
Fax
(651) 578-7077
NPI assigned
Jun 18, 2008
Last updated
Jan 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 52654 MN Primary

Addresses

Primary practice location

587 Bielenberg Dr
Suite 200
Woodbury, MN 55125-4451

Mailing address

60 Plato Blvd E
Suite270
Saint Paul, MN 55107-1827
Phone (651) 209-1600

Other identifiers 1

IdentifierTypeStateIssuer
1982865317MedicaidMN

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
I20120816000710 MN Practitioner - Dermatology 5890941298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Minnesota Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Consultants, PAGroup PAC ID 1850295676, 23 clinicians

Practice addresses (Care Compare)

1215 Town Centre Dr
Suite 200
Eagan, MN 55123-1033
Phone (651) 251-3300

3555 Willow Lake Blvd
Suite 240
Vadnais Heights, MN 55110-5131
Phone (651) 770-0110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.99 of 100Reported as group
Quality
61.48
Promoting interoperability
93
Improvement activities
40
Cost
77.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision63
Removal of skin lesions1119
Removal or shaving of skin growth54
Skin biopsy271

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52654MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Consultants, PA Dermatology CurrentSince Jul 1, 2012 Accepting new patients

Locations

60 Plato Blvd E
Ste 270
Saint Paul, MN 55107
Phone (651) 209-1600

3555 Willow Lake Blvd
Ste 240
Vadnais Heights, MN 55110
Phone (651) 770-0110

576 Bielenberg Dr
Ste 200
Woodbury, MN 55125
Phone (651) 209-1600

587 Bielenberg Dr
Ste 200
Woodbury, MN 55125
Phone (651) 578-2700

Interoperability endpoints

  • Direct secure messaging: jcook@dermcons.encitedirect.com

Organizations & group practices 1

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1982865317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PLATO BLVD E",
            "address_2": "SUITE270",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071827",
            "telephone_number": "651-209-1600",
            "fax_number": "651-291-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 BIELENBERG DR",
            "address_2": "SUITE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254451",
            "telephone_number": "651-578-2700",
            "fax_number": "651-578-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JEREMY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "52654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982865317",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.