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

Jacob Wagner, MD

Individual provider Internal Medicine Physician · NPI 1700266079

Jacob Wagner, MD is an Internal Medicine in Minneapolis, Minnesota. Graduated from University of Minnesota Medical School in 2015, 11 years ago. Practices with Fairview Health Services, a 678-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana and Minnesota.

Years since qualifying
11
Trained at
University of Minnesota Medical School
Licensed in
IN, MN
In the registry since
2015
Specialties on file
4
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

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone: (612) 672-6000
Show map & directions

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

Additional practice locations (2)

  • 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 — (317) 948-2700
  • D638 Mayo Building, Minneapolis, MN 55455 — (612) 624-3142

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 67426 (MN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 11018250A (IN)
Pediatrics Physician Taxonomy 208000000X · Licence 67426 (MN)
Pediatrics Physician Taxonomy 208000000X · Licence 01082119A (IN)

Record details

NPI number1700266079
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 2, 2015
Last updated in NPPESNovember 22, 2022
Certification dateNovember 22, 2022
Mailing address2450 Riverside Ave, Minneapolis, MN 55454-1450

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2015 (11 years in practice)
Group practice Fairview Health Services — 678 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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