NPIMap

Individual provider Active NPI

Galina L Koldoba, MD

  • Family Medicine Physician
  • Coon Rapids, MN
National Provider Identifier
1265409098
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47961 Issued in MN
Practice address
11475 Robinson Dr NW
Mail Stop 32600a
Coon Rapids, MN 55433-3746
Phone
(763) 754-4600
Fax
(763) 754-4614
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47961 MN Primary

Addresses

Primary practice location

11475 Robinson Dr NW
Mail Stop 32600a
Coon Rapids, MN 55433-3746

Mailing address

11475 Robinson Dr NW
Coon Rapids, MN 55433-3746
Phone (763) 587-9000

Other identifiers 1

IdentifierTypeStateIssuer
638978300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108000579 MN Practitioner - Family PracticePractitioner - General Surgery 3375561335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

11475 Robinson Dr NW
Coon Rapids, MN 55433-3746
Phone (763) 754-0041

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

2621 Greenhaven Rd
Anoka, MN 55303-1776
Phone (952) 853-8800

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Nov 28, 2005 Accepting new patients
Group Health, Inc. CurrentSince Nov 28, 2005 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

11475 Robinson Dr NW
Stop 32600A
Coon Rapids, MN 55433
Phone (763) 754-4600

11475 Robinson Dr NW
Minneapolis, MN 55433
Phone (763) 587-9000

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

Interoperability endpoints

  • Direct secure messaging: gkoldoba39436@direct.healthpartners.com

Organizations & group practices 4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1265409098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 ROBINSON DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333746",
            "telephone_number": "763-587-9000",
            "fax_number": "763-587-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11475 ROBINSON DR NW",
            "address_2": "MAIL STOP 32600A",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333746",
            "telephone_number": "763-754-4600",
            "fax_number": "763-754-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDOBA",
        "first_name": "GALINA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "638978300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.