NPIMap

Individual provider Active NPI

Bhaskar Chandu Kolla, M.D.

  • Hematology & Oncology Physician
  • Saint Paul, MN
National Provider Identifier
1659535615
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
56191 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3448
NPI assigned
Jul 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 56191 MN Primary
Internal Medicine Physician 207R00000X 53546 WI
Internal Medicine Physician 207R00000X 125050705 IL

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
1659535615MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 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
I20091120000419 WI Practitioner - Internal MedicinePractitioner - Hematology/Oncology 8325187982 Reassigns benefits to 3 organizations
I20130318000316 MN Practitioner - Internal Medicine 8325187982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Ladd Memorial HospitalGroup PAC ID 9931092848, shared by 3 NPIs, 69 clinicians

Practice addresses (Care Compare)

14701 Victor Hugo Blvd N
Hugo, MN 55038-4561
Phone (651) 767-1900

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

205 Wabasha Ave S
Saint Paul, MN 55107-1805

233 Radio Dr
Woodbury, MN 55125-5805
Phone (952) 967-7616

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

2600 65TH Ave
Osceola, WI 54020-4370
Phone (715) 294-2111

2831 Snelling N Ave
Roseville, MN 55113-2460
Phone (651) 636-4525

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Ladd Memorial Hospital Hospital, Osceola, WI, CCN 521318
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125050705ILMDInternal Medicine Physician
53546WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Ladd Memorial Hospital CurrentSince Jul 1, 2021 Accepting new patients
Group Health, Inc. CurrentSince Sep 13, 2021 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Health Services CurrentSince Feb 11, 2018 Accepting new patients
Ladd Memorial Hospital CurrentSince Jul 1, 2021 Accepting new patients
Group Health, Inc. CurrentSince Sep 13, 2021 Accepting new patients
Westfields Hospital, Inc. CurrentSince Sep 13, 2021 Accepting new patients
Westfields Hospital, Inc. Current Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

2600 65th Ave
Osceola, WI 54020
Phone (705) 268-8000

Interoperability endpoints

  • Direct secure messaging: bkolla702580@direct.ochin.org

Organizations & group practices 10

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1659535615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLA",
        "first_name": "BHASKAR",
        "middle_name": "CHANDU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "56191",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "53546",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125050705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659535615",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.