MEDICARE: JASON JAMES RASMUSSEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	A88529	CA
2	208600000X	Surgery Physician	43356	KY
3	208600000X	Surgery Physician	60101	MN
4	207Q00000X	Family Medicine Physician	43356	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	614122200	OTHER	KY	DEPT. OF LABOR

General Provider Information

NPI Number	:	1033191200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON JAMES RASMUSSEN M.D.

Provider Business Mailing Address
First Line	:	8351 AMSDEN RIDGE DR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1414
Country	:	US
Telephone Number	:	916-709-1622
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 E 28TH ST
Second Line	:	SUITE 300
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1139
Country	:	US
Telephone Number	:	612-863-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	12/13/2021

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