Individual provider Active NPI

Stefan Leroy Kaiser, MD

  • Occupational Medicine Physician
  • Virginia, MN
National Provider Identifier
1609037324
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
53591 Issued in MN
Practice address
1101 9TH St. N
Essentia Health Virginia Clinic
Virginia, MN 55792
Phone
(218) 741-0150
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 53591 MN Primary

Addresses

Primary practice location

1101 9TH St. N
Essentia Health Virginia Clinic
Virginia, MN 55792

Mailing address

1101 9TH St. N
Essentia Health Virginia Clinic
Virginia, MN 55792
Phone (218) 741-0150

Other identifiers 1

IdentifierTypeStateIssuer
1609037324MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110118001263 WI Practitioner - Preventive Medicine 3971792250 Reassigns benefits to 2 organizations
I20110301000151 MN Practitioner - Preventive Medicine 3971792250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

901 9TH St N
Virginia, MN 55792-2325
Phone (218) 748-7480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Oct 25, 2010 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Oct 25, 2010 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic, LTD CurrentSince Oct 25, 2010 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

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

1600 Miller Trunk Hwy
Ste 1300
Duluth, MN 55811
Phone (218) 786-3392

400 E 3rd St
#6
Duluth, MN 55805
Phone (320) 360-1676

730 E 34th St
Hibbing, MN 55746
Phone (218) 262-3425

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

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

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 8

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 1

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1609037324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST. N",
            "address_2": "ESSENTIA HEALTH VIRGINIA CLINIC",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-741-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST. N",
            "address_2": "ESSENTIA HEALTH VIRGINIA CLINIC",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-741-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "STEFAN",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MN",
            "license": "53591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609037324",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

Verify at the official NPI Registry.