NPIMap

Individual provider Active NPI

Diane M. McCaffrey, M.D.

  • Anesthesiology Physician
  • Duluth, MN
National Provider Identifier
1386692879
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
52298 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805
Phone
(218) 249-5352
Fax
(218) 249-5534
NPI assigned
May 5, 2006
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 1563 WI
Student in an Organized Health Care Education/Training Program 390200000X 49595 WI
Anesthesiology Physician 207L00000X 52298 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5352

Other practice location 1

University of Wisconsin Hospital and Clinics
600 Highland Ave. Room H4/831-8320
Madison, WI 53792-3284
Phone (608) 263-0572

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, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20091202000647 MN Practitioner - Anesthesiology 2062550460 Reassigns benefits to 3 organizations
I20200817002821 WI Practitioner - Anesthesiology 2062550460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Wisconsin School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3990

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52298MNMDAnesthesiology Physician
1563WIMDAthletic Trainer
49595WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth Anesthesiology CurrentSince May 18, 2020 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Nov 1, 2009 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Nov 1, 2009 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

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

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

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1386692879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-249-5352",
            "fax_number": "218-249-5534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Wisconsin Hospital and Clinics",
            "address_2": "600 Highland Ave. Room H4/831-8320",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537923284",
            "country_code": "US",
            "telephone_number": "608-263-0572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCAFFREY",
        "first_name": "DIANE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "1563",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "49595",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "52298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.