DR. JACOB ISAAC MIRMAN M.D.
NPI 1568404440
Internal Medicine in Saint Louis Park, MN
About Dr. Jacob Isaac Mirman M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB ISAAC MIRMAN M.D. (NPI 1568404440) is an individual internal medicine provider in Saint Louis Park, Minnesota, licensed in Minnesota (33594) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Minnesota Medical School (1987).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jacob Isaac Mirman M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jacob Mirman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Life Medical PA
- 16 clinicians in this Medicare group
St. Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- 17 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ST. LOUIS PARK, MN 55416
ST LOUIS PARK, MN 55416
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 Mirman's NPI number?
The NPI number for Jacob Mirman is 1568404440. It was assigned to this individual provider in the NPPES registry on June 12, 2006.
Where is Jacob Mirman located?
Jacob Mirman practices at 4201 Excelsior Blvd, Saint Louis Park, MN 55416. The listed phone number is (952) 933-8900.
What is Jacob Mirman's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Jacob Mirman enrolled in Medicare?
Yes. Jacob Mirman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jacob Mirman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Mirman reassigns Medicare benefits to 2 organizations: Life Medical, P.A. (Saint Louis Park, MN) and Minnesota Medical And Rehabilitative Services, LLC (St. Louis Park, 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 Mirman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacob Mirman was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Dr. Jacob Isaac Mirman, M.D. · NPI 1568404440
Internal Medicine physician in Saint Louis Park, Minnesota. Individual provider, active in the CMS NPPES registry since June 12, 2006.
## Identity
- **NPI:** 1568404440 (Entity type: Individual)
- **Enumerated:** June 12, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 33594 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 4201 EXCELSIOR BLVD, Saint Louis Park, MN 55416-4728
- **Phone:** (952) 933-8900 · **Fax:** (952) 945-9536
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Life Medical, P.A. (NPI 1740222496, Saint Louis Park, MN); Minnesota Medical And Rehabilitative Services, LLC (NPI 1154302545, St. Louis Park, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 1987
## Record status
- **NPPES last updated:** September 18, 2025
- **Other identifiers:** Medicaid 959862600 (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1568404440) · Data from the CMS NPPES public registry.