Patrick Thomas Koller

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

35944 Issued in MN

Practice address

1700 University Ave W FL 6
Saint Paul, MN 55104-3727

Phone

(651) 232-2273

NPI assigned

Mar 21, 2006

Last updated

Apr 30, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Bethesda Hospital

  • Long Term Care Hospital
  • Saint Paul, MN
  • NPI 1194787465
  Medicare reassignment NPD
• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Healtheast St. John's Hospital

  dba Fairview St John's Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Medicare reassignment NPD
• Healtheast Woodwinds Hospital

  dba Fairview Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  dba Fairview Clinics - Riverside

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1598072183
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Healtheast Care System

  dba HealthEast Home Care

  • Home Health Agency
  • Saint Paul, MN
  • NPI 1548595218
  NPD
• Healtheast Medical Research Institute

  dba HealthEast Midway Clinic

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1184670044
  NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1205895075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WEST 10TH STREET",
            "address_2": "3RD FLOOR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-232-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W FL 6",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 10th st West",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55102",
            "country_code": "US",
            "telephone_number": "651-232-3163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "35944",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MN",
            "license": "35944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359872100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32434700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Terrence Kolbeck, M.D.
• Jayme Kolbo, LPCC
• Waddie Alicia Kolenky
• Bhaskar Chandu Kolla, M.D.
• Christian Jon Kollar, D.C.
• Whitney Koller
• Nikhil Kolluri, MD
• Rosemarie Ann Kolman-Stich, LICSW
• Laurie D Koltes, MA, LP
• Craig M Kompelien, CRNA

• Interventional Cardiology Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Interventional Cardiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.

Verify at the official NPI Registry.