JENNIFER CHRISTINE HATHAWAY
NPI 1124600093
Pediatrics in Burnsville, MN

Q: What is Jennifer Hathaway's NPI number?

The NPI number for Jennifer Hathaway is 1124600093. It was assigned to this individual provider in the NPPES registry on April 21, 2021.

Q: What is Jennifer Hathaway's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Hathaway was last updated on July 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 21, 2021PECOS Enrolled

14000 FAIRVIEW DR, BURNSVILLE, MN 55337(952) 993-8700 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 19, 2024, Apr 21, 2021 (2 updates tracked since 2021).

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About Jennifer Christine Hathaway NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER CHRISTINE HATHAWAY (NPI 1124600093) is an individual pediatrics provider in Burnsville, Minnesota, licensed in Minnesota (76819) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1124600093

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJENNIFER CHRISTINE HATHAWAY

Location Address14000 FAIRVIEW DRBurnsville, MN 55337-5713

Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516

Phone(952) 993-8700

Sole ProprietorYes

Enumeration DateApril 21, 2021

Last NPPES UpdateJuly 19, 20242 updates tracked since enumeration

NPPES CertifiedJuly 19, 2024

✔ NPI 1124600093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MN · 76819

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License X000-057-306-400 (MN)

14000 FAIRVIEW DR, Burnsville, MN 55337

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Secondary Practice Location 1

Location 1717 Delaware St SE Ste 353Minneapolis, MN 55414-2959 · Phone (612) 626-3761

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Christine Hathaway is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Hathaway reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Park Nicollet Methodist Hospital

13 mi

General Acute Care Hospital

3900 PARK NICOLLET BLVD
St Louis Park, MN 55416

Reassigned Medicare billing, Minnesota enrollment
Medicare enrollment name: Park Nicollet Clinic
2,527 clinicians in this Medicare group

NPI 1194113217 (952) 993-1953

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55337 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY MARTINEZ PT

Physical Therapist