NPIMap

Individual provider Active NPI

Michael B Kowalski, M.D.

  • Internal Medicine Physician
  • Duluth, MN
National Provider Identifier
1447306683
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24546 Issued in OK
Practice address
400 East 3Rd Street
Duluth, MN 55805
Phone
(218) 786-8132
NPI assigned
Jan 27, 2007
Last updated
Sep 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24546 OK Primary

Addresses

Primary practice location

400 East 3Rd Street
Duluth, MN 55805

Mailing address

400 East 3Rd Street
Duluth, MN 55805
Phone (218) 786-8132

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
I20081015000657 MN Practitioner - Internal Medicine 4385702653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24546OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Oct 3, 2011 Accepting new patients
Park Nicollet Clinic CurrentSince Oct 3, 2011 Accepting new patients
Park Nicollet Methodist Hospital Past Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

6500 Excelsior Blvd
Ste 2260
St Louis Park, MN 55426
Phone (952) 993-5000

Organizations & group practices 3

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1447306683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST 3RD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST 3RD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "24546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.