NPIMap

Individual provider Active NPI

Katie M Sackett, D.O.

  • Clinical Pathology Physician
  • Duluth, MN
National Provider Identifier
1376988980
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
76941 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X 68613 WI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036173602 IL
Clinical Pathology Physician 207ZC0006X 76941 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

931 Noel CT
Westmont, IL 60559-2689
Phone (630) 333-0580

Other practice location 1

931 Noel Ct
Westmont, IL 60559-2689
Phone (630) 333-0580

Other practice location 2

300 Randall Rd # Ll
Geneva, IL 60134-4200
Phone (630) 208-4201

Other names 1

  • Katie Koenig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, IL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180625000947 WI Practitioner - Pathology 2961706288 Reassigns benefits to 1 organization
I20240621003863 MN Practitioner - Pathology 2961706288 Reassigns benefits to 1 organization
I20250324000508 IL Practitioner - Pathology 2961706288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Midwestern University, Chicago College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Arlington Ridge Pathology SCGroup PAC ID 2567441785, 9 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

800 W Central Rd
Northwest Community Hospital
Arlington Heights, IL 60005-2349
Phone (847) 618-6150

Hospital & facility affiliations

  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25691MNMDClinical Social Worker
76941MNMDClinical Pathology Physician
68613WIMDClinical Pathology Physician
036173602ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD CurrentSince Jul 8, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2025 Accepting new patients
Black River Health Inc CurrentSince Jul 23, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2025 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 8, 2024 Accepting new patients
Black River Memorial Hospital Inc CurrentSince Jul 23, 2019 Accepting new patients
Black River Health Inc Current Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

Organizations & group practices 9

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1376988980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 NOEL CT",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592689",
            "telephone_number": "630-333-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "931 Noel Ct",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605592689",
            "country_code": "US",
            "telephone_number": "630-333-0580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Randall Rd # Ll",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-208-4201",
            "fax_number": "630-208-3489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKETT",
        "first_name": "KATIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "WI",
            "license": "68613",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036173602",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "MN",
            "license": "76941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "KOENIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.