JACQUELYN FAITH MIRR MD
NPI 1679132989
Obstetrics & Gynecology in Woodbury, MN

Active since June 10, 2019PECOS EnrolledAccepts Medicare Assignment
1687 WOODLANE DR STE AND102, WOODBURY, MN 55125(651) 600-3035 Get Directions Write a Review

NPPES record last updated: September 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2023, Oct 18, 2019, Jun 10, 2019 (3 updates tracked since 2019).

About Jacquelyn Faith Mirr Md NPPES

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

JACQUELYN FAITH MIRR MD (NPI 1679132989) is an individual obstetrics & gynecology provider in Woodbury, Minnesota, licensed in Minnesota (74576) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Maplewood, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1679132989
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameJACQUELYN FAITH MIRRCredential: MD
Location Address1687 WOODLANE DR STE AND102Woodbury, MN 55125-3045
Mailing Address1687 Woodlane Dr Ste 101&102Woodbury, MN 55125-3045 · (651) 600-3035 · Fax (651) 348-8783
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateJune 10, 2019
Last NPPES UpdateSeptember 29, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2023
NPI 1679132989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License Licensed in MN · 74576
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1687 WOODLANE DR STE AND102, Woodbury, MN 55125

Other Names 1

Former Name (1)Jacquelyn Faith Porter

Secondary Practice Location 1

Location 12603 White Bear Ave NMaplewood, MN 55109-5110 · Phone (651) 348-8783 · Fax (651) 528-6149

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacquelyn Faith Mirr Md 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.

PECOS PAC ID9537495635
PECOS Enrollment IDI20240415002912
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55125 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
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jacquelyn Mirr's NPI number?

The NPI number for Jacquelyn Mirr is 1679132989. It was assigned to this individual provider in the NPPES registry on June 10, 2019. The provider is also known as Jacquelyn Faith Porter.

Where is Jacquelyn Mirr located?

Jacquelyn Mirr practices at 1687 Woodlane Dr Ste And102, Woodbury, MN 55125. The listed phone number is (651) 600-3035.

What is Jacquelyn Mirr's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Jacquelyn Mirr enrolled in Medicare?

Yes. Jacquelyn Mirr 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.

What insurance does Jacquelyn Mirr accept?

Health plans from HealthPartners, Medica and Sanford Health Plan list Jacquelyn Mirr 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 Jacquelyn Mirr was last updated on September 29, 2023. 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.