NPIMap

Individual provider Active NPI

Krista U Warren, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Duluth, MN
National Provider Identifier
1578613485
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
44497 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 44497 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

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

Other identifiers 6

IdentifierTypeStateIssuer
625S6WAOtherMNBLUES
483915300MedicaidMN
1035003OtherMNPREFERRED ONE
34446600MedicaidWI
P00061181OtherMNRR MEDICARE
1100335OtherMNMEDICA

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
I20101218000025 MN Practitioner - Pathology 0749478618 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44497MNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD CurrentSince Jun 23, 2014 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 23, 2014 Accepting new patients
St. Joseph'S Medical Center CurrentSince Nov 16, 2017 Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 1, 2020 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2013 Accepting new patients
Essentia Health Moose Lake CurrentSince Aug 1, 2020 Accepting new patients
St Joseph'S Medical Center CurrentSince Nov 16, 2017 Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2013 Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

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

915 E 1st St
Ste 302
Duluth, MN 55805
Phone (218) 249-5208

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 11

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1578613485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "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": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "KRISTA",
        "middle_name": "U",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "44497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES",
            "identifier": "625S6WA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483915300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1035003",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34446600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00061181",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1100335",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.