Active NPI
Kevin John Dalpiaz, PA-C
- Physician Assistant
- Duluth, MN
National Provider Identifier
1033452081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11334
- Practice address
- 1012 E 2ND St
Duluth, MN 55805-2200 - Phone
- (218) 249-6360
- Fax
- (218) 249-6370
- NPI assigned
- Mar 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11334 | MN | Primary |
Addresses
Primary practice location
1012 E 2ND St
Duluth, MN 55805-2200
Mailing address
1012 E 2ND St
Duluth, MN 55805-2200
Phone (218) 249-6360
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001-0103100 | Other | MN | MEDICA |
| 1033452081 | Medicaid | MN | |
| 1033452081 | Medicaid | WI | |
| 1033452081 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@slk.direct.slhduluth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11334 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current | Accepting new patients |
Locations
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Essentia Health Cloquet Clinic
- Multi-Specialty Clinic/Center
- Cloquet, MN
- NPI 1902563638
-
dba Essentia Health Miller Hill Clinic
- Multi-Specialty Clinic/Center
- Duluth, MN
- NPI 1245855162
-
dba Essentia Health Hinckley Pharmacy
- Community/Retail Pharmacy
- Hinckley, MN
- NPI 1245081066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1033452081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 E 2ND ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052200",
"telephone_number": "218-249-6360",
"fax_number": "218-249-6370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 E 2ND ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052200",
"telephone_number": "218-249-6360",
"fax_number": "218-249-6370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALPIAZ",
"first_name": "KEVIN",
"middle_name": "JOHN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-28",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "11334",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0001-0103100",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033452081",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033452081",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033452081",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@slk.direct.slhduluth.com",
"affiliation": "N",
"address_1": "1012 E 2nd St",
"city": "Duluth",
"state": "MN",
"country_code": "US",
"postal_code": "558052200",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.