Neeti Kambale, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

64113 Issued in MN

Practice address

14701 Victor Hugo Blvd N
Hugo, MN 55038

Phone

(651) 426-1141

Fax

(651) 426-1705

NPI assigned

Jun 4, 2015

Last updated

Sep 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Children's Clinic Network

  dba Children's Hugo Clinic

  • Primary Care Clinic/Center
  • Hugo, MN
  • NPI 1447529235
  Medicare reassignment NPD
• Children's Clinic Network

  dba Partners in Pediatrics

  • Primary Care Clinic/Center
  • Maple Grove, MN
  • NPI 1013278720
  NPD
• Children's Clinic Network

  dba Children's Brooklyn Park Clinic

  • Primary Care Clinic/Center
  • Brooklyn Park, MN
  • NPI 1588522668
  NPD
• Metropolitan Pediatric Specialists, P.a.

  • Clinic/Center
  • Edina, MN
  • NPI 1558459206
  NPD (past)

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1215317193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 VICTOR HUGO BLVD N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550384561",
            "telephone_number": "651-426-1141",
            "fax_number": "651-426-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 VICTOR HUGO BLVD N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "55038",
            "telephone_number": "651-426-1141",
            "fax_number": "651-426-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBALE",
        "first_name": "NEETI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "64113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Hydukovich, RDN, LD, CDE
• Maggi Leigh Johnson, M.D.
• Michele Terese-Marie Jones
• Karla Rae Juvonen, PA
• Michael Dennis Kalos, DNP, RN, CWOCN
• Kevin L Kampfe, MD
• Katie Kapphahn
• Amy Kauffman
• Paige Kedrowski
• Jade Kelm

• Pediatrics Physician in Hugo, MN
• Providers in Hugo, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.