NPIMap

Individual provider Active NPI

Nathan Jon Palmolea, DO

  • Hospitalist Physician
  • Duluth, MN
National Provider Identifier
1609211606
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
58153 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 3, 2013
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58153 MN
Hospitalist Physician 208M00000X 58153 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Credentialing Dept., McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151007003323 MN Practitioner - HospitalistPractitioner - Family PracticePractitioner - Emergency Medicine 5991013153 Reassigns benefits to 1 organization
I20200423002134 WI Practitioner - Family PracticePractitioner - Hospitalist 5991013153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Northern Pines Medical CenterGroup PAC ID 3870565641, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

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

5211 Hwy 110
Aurora, MN 55705-1522
Phone (218) 229-3311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58153MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 15, 2016 Accepting new patients
The Duluth Clinic, LTD CurrentSince Aug 15, 2016 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Mar 1, 2020 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
SMDC Medical Center Past Accepting new patients
St Marys Medical Center Past Accepting new patients

Locations

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

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

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

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

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Benedictine Health CenterDuluth, MN, CCN 245236 Skilled nursing facility Corporate Director Apr 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 7

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": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1609211606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "CREDENTIALING DEPT., MCL2CRED",
            "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": "PALMOLEA",
        "first_name": "NATHAN",
        "middle_name": "JON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-03",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58153",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "58153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.