Active NPI
Jacub Michael Kaliszewski, PHARMD, RPH
- Pharmacist
- Duluth, MN
National Provider Identifier
1215212204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120242
- Practice address
- 4501 Grand Ave
Duluth, MN 55807-2754 - Phone
- (218) 628-2897
- Fax
- (218) 624-5853
- NPI assigned
- Oct 21, 2011
- Last updated
- Oct 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 120242 | MN | Primary |
| Pharmacist | 183500000X | 16057-040 | WI |
Addresses
Primary practice location
4501 Grand Ave
Duluth, MN 55807-2754
Mailing address
4501 Grand Ave
Duluth, MN 55807-2754
Phone (218) 628-2897
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120242 | MN | MD | Pharmacist |
| 16057-040 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1319155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1215212204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 GRAND AVE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558072754",
"telephone_number": "218-628-2897",
"fax_number": "218-624-5853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 GRAND AVE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558072754",
"telephone_number": "218-628-2897",
"fax_number": "218-624-5853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALISZEWSKI",
"first_name": "JACUB",
"middle_name": "MICHAEL",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-21",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120242",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "16057-040",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.