Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jason D. Mallow, MD

Individual provider Diagnostic Radiology Physician · NPI 1235423187

Dr. Jason D. Mallow, MD is a Diagnostic Radiology in Edina, Minnesota. Graduated from University of Miami, Lm Miller School of Medicine in 2011, 15 years ago. Practices with Northside Radiology Associates LLC, a 384-clinician group. Licensed in Georgia and Virginia.

Years since qualifying
15
Trained at
University of Miami, Lm Miller School of Medicine
Licensed in
GA, VA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone: (952) 595-1301
Fax: (612) 294-4903
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 0101252666 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 81764 (GA)

Record details

NPI number1235423187
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 7, 2011
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Northside Radiology Associates Llc — 384 clinicians
Accepts Medicare assignment Not indicated
Practice locations11 on file with Medicare

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