Individual provider Active NPI

Emily Korman, D.O.

  • Pediatrics Physician
  • Sartell, MN
National Provider Identifier
1063827236
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R-10086 Issued in IA
Practice address
111 2ND St S
Sartell, MN 56377-1917
Phone
(320) 281-3339
Fax
(320) 200-7505
NPI assigned
Jun 26, 2014
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R-10086 IA Primary

Addresses

Primary practice location

111 2ND St S
Sartell, MN 56377-1917

Mailing address

3290 42ND Ave S
Ste 100
Saint Cloud, MN 56301-6251
Phone (320) 227-5010

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210407001958 MN Practitioner - Pediatric Medicine 4486870136 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Apr 4, 2022 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 4, 2022 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Sartell Pediatrics, P.a. Pediatrics PastSince May 19, 2021 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12435/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1063827236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 42ND AVE S",
            "address_2": "STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016251",
            "telephone_number": "320-227-5010",
            "fax_number": "320-227-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771917",
            "telephone_number": "320-281-3339",
            "fax_number": "320-200-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORMAN",
        "first_name": "EMILY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-10086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.