1. Home
  2. Directory
  3. Minnesota
  4. Minneapolis
  5. Pain Medicine
  6. NPI Profile

DR. JACOB COOPER DEWEERTH M.D.
NPI 1306265582
Pain Medicine - Pain Medicine in Minneapolis, MN

Active since April 15, 2014PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 672-6000 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 5, 2025, Jul 29, 2019, Jul 24, 2019 (3 updates tracked since 2019).

About Dr. Jacob Cooper Deweerth M.d. NPPES

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

DR. JACOB COOPER DEWEERTH M.D. (NPI 1306265582) is an individual pain medicine provider in Minneapolis, Minnesota, licensed in Minnesota (65497) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306265582
Entity TypeIndividualMale
Primary Taxonomy208VP0000X
Provider Legal NameDR. JACOB COOPER DEWEERTHCredential: M.D.
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address1 Veterans Drive, Department Of Rehabilitation And Physical MedicineMinneapolis, MN 55417-2309 · (612) 467-4646 · Fax (612) 467-2333
Phone(612) 672-6000
Sole ProprietorNo
Enumeration DateApril 15, 2014
Last NPPES UpdateFebruary 5, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2025
✔ NPI 1306265582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0000X
License✔ Licensed in MN · 65497
Definition
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Also ListedAnesthesiologyTaxonomy 207L00000X · License 65497 (MN)
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X · License 65497 (MN)
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Cooper Deweerth M.d. 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 Reassignments

5

Medicare enrollment records show Jacob Deweerth reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
Same address
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
University Anesthesia Providers, LLC
Same address
Anesthesiology
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 681 clinicians in this Medicare group
NPI 1699711143 (612) 273-3000
University Of Minnesota Health Clinics And Surgery Center Inc
0.7 mi
Anesthesiology
909 FULTON ST SE
Minneapolis, MN 55455
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,662 clinicians in this Medicare group
NPI 1003485004 (612) 273-8383
Fairview Maple Grove Surgery Center, LLC
16 mi
Anesthesiology
14500 99TH AVE N STE 500
Maple Grove, MN 55369
  • Reassigned Medicare billing, Minnesota enrollment
  • 226 clinicians in this Medicare group
NPI 1730068032 (855) 324-7843

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 55454 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
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.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Deweerth's NPI number?

The NPI number for Jacob Deweerth is 1306265582. It was assigned to this individual provider in the NPPES registry on April 15, 2014.

Where is Jacob Deweerth located?

Jacob Deweerth practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 672-6000.

What is Jacob Deweerth's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Is Jacob Deweerth enrolled in Medicare?

Yes. Jacob Deweerth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jacob Deweerth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Deweerth reassigns Medicare benefits to 5 organizations: Fairview Express Care (Minneapolis, MN), Fairview Health Services (Minneapolis, MN), University Anesthesia Providers, LLC (Minneapolis, MN), University Of Minnesota Health Clinics And Surgery Center Inc (Minneapolis, MN) and Fairview Maple Grove Surgery Center, LLC (Maple Grove, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Deweerth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacob Deweerth accept?

Health plans from Sanford Health Plan list Jacob Deweerth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Deweerth was last updated on February 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.