Active NPI
Pamela Kolacz, M.D.
- Family Medicine Physician
- Maple Grove, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 42205
- Practice address
- 6320 Wedgwood Rd N
Maple Grove, MN 55311-3647 - Phone
- (763) 268-0400
- Fax
- (763) 268-0405
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 42205 | MN | Primary |
Addresses
Primary practice location
6320 Wedgwood Rd N
Maple Grove, MN 55311-3647
Mailing address
6320 Wedgwood Rd N
Maple Grove, MN 55311-3647
Phone (763) 268-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22G83KO | Other | MN | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15650 Cedar Ave
Apple Valley, MN 55124-7283
Phone (952) 997-4100
Hospital & facility affiliations
- M Health Fairview University of MN Medical Center
- Abbott Northwestern Hospital
- M Health Fairview Southdale Hospital
- Fairview Northland Regional Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Family Medicine | Current | Accepting new patients |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Past | Accepting new patients |
Locations
15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203
10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999
6320 Wedgwood Rd N
Osseo, MN 55311
Phone (763) 268-0400
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
Interoperability endpoints
- pkolacz7791@fairview.direct-ci.com
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Primary Care Clinic/Center
- Eden Prairie, MN
- NPI 1336331297
-
- Family Medicine Physician
- Princeton, MN
- NPI 1952779266
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Multi-Specialty Clinic/Center
- Maple Grove, MN
- NPI 1841315165
Hospital & facility affiliations 30
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334275200000",
"number": "1205852480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6320 WEDGWOOD RD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553113647",
"telephone_number": "763-268-0400",
"fax_number": "763-268-0405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 WEDGWOOD RD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553113647",
"telephone_number": "763-268-0400",
"fax_number": "763-268-0405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLACZ",
"first_name": "PAMELA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2012-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "42205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "22G83KO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.