Kelly Jo Greenleaf

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

49526 Issued in MN

Practice address

400 E 3Rd St
Duluth, MN 55805-1951

Phone

(218) 786-3800

NPI assigned

Sep 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Obstetrics/Gynecology

Education

University of Minnesota Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
• Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Essentia Health Moose Lake

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1154959880
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment NPD
• Polinsky Medical Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Duluth, MN
  • NPI 1639237746
  Care Compare group
• Essentia Health Moose Lake

  • Critical Access Hospital Clinic/Center
  • Moose Lake, MN
  • NPI 1275102048
  NPD
• Essentia Health Virginia, LLC

  • Multi-Specialty Clinic/Center
  • Ely, MN
  • NPI 1962440362
  NPD
• Moose Lake Community Hospital District

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1942398029
  NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Hermantown, MN
  • NPI 1235176058
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  NPD (past)
• The Duluth Clinic, LTD

  • Anesthesiology Physician
  • Duluth, MN
  • NPI 1760417935
  NPD (past)

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

• St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Care Compare affiliation
• St. Marys Medical Center

  • Air Ambulance
  • Duluth, MN
  • NPI 1841359478

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1174718316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEAF",
        "first_name": "KELLY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "49526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090903300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Anne Greeman, APRN, CNP
• Joanna Marie Green, MSW, LGSW
• Tayler Green
• Janis A Greene, LSW
• Brenna Greenfield
• Breanna Joy Greenly, MSW, LICSW
• Thomas Rieter Greenwood, DO
• Adam Michael Greer, DO
• Paul Thomas Gregg, MD
• Tyler Michael Gregg, APRN, CRNA

• Obstetrics & Gynecology Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.