Jonathan Frank Kalisvaart, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

MD 60207055 Issued in WA

Practice address

101 W 8TH Ave
Suite 100
Spokane, WA 99204-2307

Phone

(509) 624-3126

Fax

(509) 227-7070

NPI assigned

Oct 29, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Baylor College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077
• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
• Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkalisvaart206577@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  dba Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  dba MultiCare Deaconess Hospital

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1356528269
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Valley Hospital

  • General Acute Care Hospital
  • Spokane Valley, WA
  • NPI 1538345251
  Care Compare affiliation
• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Providence Health & Services - Washington

  dba Providence Holy Family Hospital

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1225289895
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013196864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "address_2": "SUITE 100",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-624-3126",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISVAART",
        "first_name": "JONATHAN",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A93105",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "GA",
            "license": "062232",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "WA",
            "license": "MD 60207055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127902334A",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkalisvaart206577@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 W 8th Ave",
            "address_2": "Suite 100",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deana Laree Kalberg, BSW
• Ravinder Kaler, MD
• Kathryn J Kaley, CASE MANAGER
• Rheanna Kaley, PHD
• Jennifer L Kalisvaart, M.D.
• Hardeep Singh Kalkat, PHARMD., RPH
• Jeffrey Kalles, M.S., BCBA
• Catherine Emily Kallsen, RN
• Tracy L Kaluzny, PNP
• Kandon Kawawahilani Kamae, M.D.

• Pediatric Urology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Pediatric Urology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.