Active NPI
Kristen Marie Kallestad, M.D., PH.D.
- Family Medicine Physician
- Winsted, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 58074
- Practice address
- 551 4TH St N
Winsted, MN 55395-4523 - Phone
- (952) 442-3190
- NPI assigned
- Apr 23, 2012
- Last updated
- Oct 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 58074 | MN | Primary |
Addresses
Primary practice location
551 4TH St N
Winsted, MN 55395-4523
Mailing address
PO Box 718
Winsted, MN 55395-0718
Other practice location 1
1020 W Broadway Ave
Minneapolis, MN 55411-2504
Phone (612) 302-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58074 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northfield Hospital | Current | Accepting new patients | |
| Ridgeview Medical Center | Multi-Specialty | Current | Accepting new patients |
| Sibley Medical Center | Multi-Specialty | Current | Accepting new patients |
| Ridgeview Medical Center | Past | Accepting new patients |
Locations
601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271
4645 Knutsen Dr
Farmington, MN 55024
Phone (651) 460-2300
2000 North Ave
Northfield, MN 55057
Phone (507) 646-1000
500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191
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.
-
dba Ridgeview Medical Center CRNAs
- Certified Registered Nurse Anesthetist
- Waconia, MN
- NPI 1528364429
Multi-Specialty
-
dba Ridgeview Sibley Medical Center
- Critical Access Hospital
- Arlington, MN
- NPI 1740240225
Multi-Specialty
-
- Rural Acute Care Hospital
- Northfield, MN
- NPI 1417990805
-
dba Northfield Hospital & Clinics - Northfield Clinic
- Multi-Specialty Clinic/Center
- Northfield, MN
- NPI 1255367629
-
- General Acute Care Hospital
- Waconia, MN
- NPI 1275608457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508457600000",
"number": "1467719864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 718",
"city": "WINSTED",
"state": "MN",
"postal_code": "553950718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 4TH ST N",
"city": "WINSTED",
"state": "MN",
"postal_code": "553954523",
"telephone_number": "952-442-3190"
}
],
"practiceLocations": [
{
"address_1": "1020 W Broadway Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554112504",
"country_code": "US",
"telephone_number": "612-302-8200",
"fax_number": "612-521-4725",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KALLESTAD",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-23",
"last_updated": "2017-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "58074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winsted, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.