NPIMap

Individual provider Active NPI

Kent Joseph Donelan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Willmar, MN
National Provider Identifier
1447442181
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
53314 Issued in MN
Practice address
301 Becker Ave SW
Willmar, MN 56201-3302
Phone
(320) 231-4500
NPI assigned
Aug 16, 2007
Last updated
Oct 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 104875 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 53314 MN Primary

Addresses

Primary practice location

301 Becker Ave SW
Willmar, MN 56201-3302

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidIA
ENROLLEDMedicaidMN

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
I20100831001007 MN Practitioner - Pathology 2961526785 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Sanford School of Medicine of University of South Dakota, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians
Minnesota Pathologists CharteredGroup PAC ID 7911003835, 4 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

301 Becker Ave SW
Willmar, MN 56201-3302

301 Becker Ave SW
Willmar, MN 56201-3395

301 Becker Swave
Willmar, MN 56201-3395
Phone (320) 235-4543

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53314MNMDAnatomic Pathology & Clinical Pathology Physician
104875MNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Jan 1, 2022 Accepting new patients
Douglas County Hospital Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jan 1, 2022 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jan 1, 2022 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jan 1, 2022 Accepting new patients
Minnesota Pathologists Chartered Anatomic Pathology & Clinical Pathology CurrentSince Nov 28, 2011 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

111 17th Ave E
Ste 101
Alexandria, MN 56308
Phone (320) 762-1144

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
  • Direct secure messaging: kdonelan29728@direct.centracare.com

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

Hospital & facility affiliations 9

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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1447442181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BECKER AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013302",
            "telephone_number": "320-231-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELAN",
        "first_name": "KENT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "104875",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "53314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.