NPIMap

Individual provider Active NPI

Callie Kunze, P.A.

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1326322017
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11491 Issued in MN
Practice address
920 E 1St St
Suite 302
Duluth, MN 55805-2201
Phone
(218) 249-6050
Fax
(218) 249-6055
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11491 MN Primary

Addresses

Primary practice location

920 E 1St St
Suite 302
Duluth, MN 55805-2201

Mailing address

920 E 1St St
Suite 302
Duluth, MN 55805-2201
Phone (218) 249-6050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

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
I20160104000362 MN Practitioner - Physician Assistant 6800063629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

920 E 1St St
Duluth, MN 55805-2225

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11491MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Dec 30, 2015 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 30, 2015 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

920 E 1st St
Ste 302
Duluth, MN 55805
Phone (218) 249-6050

920 E 1st St
Ste P101
Duluth, MN 55805
Phone (218) 279-6200

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

Interoperability endpoints

  • Direct secure messaging: him@slk.direct.slhduluth.com
  • Direct secure messaging: ckunze237269@direct.aspirus.org

Organizations & group practices 5

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1326322017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "SUITE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-6050",
            "fax_number": "218-249-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "SUITE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-6050",
            "fax_number": "218-249-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNZE",
        "first_name": "CALLIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "920 E 1st St",
            "address_2": "Suite 302",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.