DR. JACOB ISAAC MIRMAN (M.D.) – Internal Medicine Physician, NPI 1568404440
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,636 INTERNAL MEDICINE in MN
Provider Addresses for DR. JACOB ISAAC MIRMAN (M.D.)
4201 EXCELSIOR BLVD
ST LOUIS PARK, MN 554164728
Phone: (952) 933-8900
Fax: (952) 945-9536
Type: Mailing
Dreamers Vault Games, 3015, Utah Avenue South, Aquila, Saint Louis Park, Hennepin County, Minnesota, 55426, United States
SUITE 200
SAINT LOUIS PARK, MN 554263671
Phone: (952) 933-1121
Fax: (952) 945-9635
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2023-10-09 • Largest payer in this snapshot: Novo Nordisk Inc ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070322000334 | I | Internal Medicine | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 148 | 128 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 55416)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | MN | |
| Clinical Psychologist | MN | |
| Family Practice | MN | |
| C H I R O P R A C T I C | MN | |
| - | MN | |
| Internal Medicine, General Surgery | MN | |
| Clinical Social Worker | MN | |
| Internal Medicine | MN | |
| Pain Management | MN | |
| Physical Therapist In Private Practice | MN |
Reviews
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