JACK DOENGES MD
NPI 1790305605
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since April 21, 2020PECOS EnrolledAccepts Medicare Assignment
420 DELAWARE STREET SE, MMC 195, MINNEAPOLIS, MN 55455(612) 301-9433 Get Directions Write a Review

NPPES record last updated: April 21, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jack Doenges Md NPPES

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

JACK DOENGES MD (NPI 1790305605) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview Southdale Hospital, and is a graduate of University Of Minnesota Medical School (2020).

NPPES Registry Identity

NPI1790305605
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK DOENGESCredential: MD
Location Address420 DELAWARE STREET SE, MMC 195Minneapolis, MN 55455-0341
Mailing Address420 Delaware Street Se, Mmc 195Minneapolis, MN 55455-0341
Sole ProprietorYes
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 2020
Enumeration DateApril 21, 2020
NPPES CertifiedApril 21, 2020
NPI 1790305605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

420 DELAWARE STREET SE, Minneapolis, MN 55455

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

Jack Doenges 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 ID2365942802
PECOS Enrollment IDI20250820003490
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

M Health Fairview Southdale Hospital

Acute Care Hospitals · Edina, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240078
Location6401 France Avenue SouthEdina, MN 55435 · Hennepin County
Emergency services Birthing friendly

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.

Internal Medicine
420 DELAWARE STREET SE, UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS, MN 55455
Pathology (Clinical Pathology/Laboratory Medicine)
420 DELAWARE STREET SE, 760 MAYO MEMORIAL BUILDING
MINNEAPOLIS, MN 55455
Pathology (Clinical Pathology/Laboratory Medicine)
420 DELAWARE STREET SE, ROOM 760 MAYO MEMORIAL BUILDING
MINNEAPOLIS, MN 55455
Anesthesiology
420 DELAWARE STREET SE, B515 MAYO MEMORIAL BUILDING, MMC 294
MINNEAPOLIS, MN 55455
General Acute Care Hospital
420 DELAWARE STREET SE, MAYO MAIL CODE 293
MINNEAPOLIS, MN 55455
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 284 14-100 PHILLIPS-WANGENSTEEN BLDG
MINNEAPOLIS, MN 55455
Clinical Medical Laboratory
420 DELAWARE STREET SE
MINNEAPOLIS, MN 55455
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, PHILLIPS-WANGENSTEEN BUILDING 11-145E, MMC195
MINNEAPOLIS, MN 55455

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790305605, enumerated as an "individual" on April 21, 2020.

The provider is located at 420 DELAWARE STREET SE MMC 195 MINNEAPOLIS, MN 55455 and the phone number is (612) 301-9433.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

The provider might be accepting Accepts: HealthPartners. Please consult your insurance carrier or call the provider to verify.

Jack Doenges is affiliated with: M HEALTH FAIRVIEW SOUTHDALE HOSPITAL.