Jacob R Hodge (NPI# 1811158256, PAC ID# 3072668193) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1811158256 |
| PAC ID by PECOS | 3072668193 |
| Professional Enrollment ID | I20090825000751 |
| Full Name | Jacob R Hodge |
| Organization Legal Name | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| Address |
11225 Ulysses St Ne Suite 110 Blaine MN 55434-4261 |
| Phone Number | 9528379700 |
| Gender | M |
| Medical School | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
| Graduation Year | 2008 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2466357272 |
| Number of Group Practice Members | 69 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240115 | MERCY HOSPITAL |
| 240076 | BUFFALO HOSPITAL |
| 241343 | MUNICIPAL HOSPITAL AND GRANITE MANOR |
| 241365 | SWIFT COUNTY BENSON HOSPITAL |
| 240078 | FAIRVIEW SOUTHDALE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 | 9528379700 | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| 11850 Blackfoot St Nw, Suite 180, Coon Rapids, MN 55433-2775 | 7637951600 | SUBURBAN IMAGING LLC |
| 8990 Springbrook Dr Nw, Suite 140, Coon Rapids, MN 55433-5880 | 7637921900 | SUBURBAN IMAGING LLC |
| 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 7637809155 | ALLINA HEALTH SYSTEM |
| 6545 France Ave S, Suite 125, Edina, MN 55435-2357 | 9524052777 | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| 250 Thompson St, Saint Paul, MN 55102-2370 | 6512976504 | MIDWEST RADIOLOGY PA |
| Organization Legal Name | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| Physicians | 65 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan P Williams | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Mark D Mcmillan | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 4050 Coon Rapids Nwblvd, Coon Rapids, MN 55433-2522 |
| Paul Robert Oler | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| Mark E Wilson | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Brian F Decesare | Interventional Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Jennifer Williams | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Karl T Nelsen | Physician Assistant | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| John A Coburn | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| David A Asinger | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Fareed Siddiqui | Interventional Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| Street Address |
11225 ULYSSES ST NE SUITE 110 |
| City | BLAINE |
| State | MN |
| Zip | 55434-4261 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan P Williams | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Samuel J Arnold | Physical Therapy | Infinite Health Collaborative Pa | 11225 Ulysses St Ne, Blaine, MN 55434-4261 |
| David A Asinger | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Gregory M Phelan | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Amanda L Tschida-schirmers | Occupational Therapy | Infinite Health Collaborative Pa | 11225 Ulysses St Ne, Blaine, MN 55434-4261 |
| Lanning W Houston | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Mark R Tollefsrud | Physical Therapy | Infinite Health Collaborative Pa | 11225 Ulysses St Ne, Blaine, MN 55434-4261 |
| Crystal D Tainter | Physical Therapy | Infinite Health Collaborative Pa | 11225 Ulysses St Ne, Blaine, MN 55434-4261 |
| Brian S Martell | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Brian T Sullivan | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allison Lynn Wiedemann | Optometry | Ocularra Holding Inc | 570 Northtown Mall, Blaine, MN 55434 |
| Chad M Krietlow | Optometry | Complete Eyecare P L C | 260 Northtown Dr Ne, Blaine, MN 55434-1037 |
| Robert M Chous | Optometry | Visionworks Inc | 212 Northtown Dr, Suite H7a, Blaine, MN 55434-1039 |
| Lance Kevin Maki | Chiropractic | 607 County Rd 10 Ne, Suite 104, Blaine, MN 55434-3287 | |
| Angela M Laughlin | Nurse Practitioner | Arthritis Clinic and Medical Associates P.c | 11937 Central Ave Ne, Blaine, MN 55434-3911 |
| Thomas C Rice | Chiropractic | Blaine Chiropracitc Center Pa | 11919 Central Ave Ne, Blaine, MN 55434-3911 |
| Nichole A Rakow | Chiropractic | 11901 Central Neave, Blaine, MN 55434-3911 | |
| Ashley E Jerde | Chiropractic | Blaine Chiropracitc Center Pa | 11919 Central Ave Ne, Blaine, MN 55434-3911 |
| Michael T Hample | Chiropractic | Blaine Chiropracitc Center Pa | 11919 Central Ave Ne, Blaine, MN 55434-3911 |
| Steven J Kavros | Podiatry | Vascular Surgery Associates | 11855 Ulysses St Ne, Blaine, MN 55434-3947 |
| Find all physicians in zip 55434 | |||
| City | BLAINE |
| Zip Code | 55434 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | BLAINE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jacob R Hodge.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.