NPIMap

Andrew A Hollatz, M.D.

Individual provider Active NPI Anesthesiology Physician · Duluth, MN

NPI 1154525087 · NPPES record last updated Dec 4, 2020

Key facts

NPI
1154525087
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
62901 (MN)
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(218) 249-5352
Fax
(218) 249-5534
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 12

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.

Hospital & facility affiliations 26

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

View all 26

Medicare Care Compare profile

Specialty
Anesthesiology
Education
University of Minnesota Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of Duluth (409 clinicians)

Practice addresses (Care Compare)

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3990

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Hospital & facility affiliations

  • St Lukes Hospital Hospital · Duluth, MN · CCN 240047

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI, MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110722000618 WI Practitioner - Anesthesiology 5597933242 Reassigns benefits to 1 organization
I20171219003504 MN Practitioner - Anesthesiology 5597933242 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62901MNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Anesthesiology Current
since May 13, 2020		 Accepting new patients
St. Luke'S Hospital of Duluth Current
since Dec 1, 2017		 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth Current
since Dec 1, 2017		 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

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

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

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 62901 MN Yes

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5352

Other practice location 1

600 Highland Ave # H4-831
Madison, WI 53792-0001
Phone (608) 263-0572

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 4, 2020.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1154525087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave # H4-831",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-0572",
            "fax_number": "608-890-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLATZ",
        "first_name": "ANDREW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "62901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

All providers in Duluth, MN · Anesthesiology Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.