NPIMap

Individual provider Active NPI

John Matthew Holst, D.O.

  • Emergency Medicine Physician
  • Duluth, MN
National Provider Identifier
1669442406
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
56179 Issued in MN
Practice address
407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950
Phone
(218) 786-4357
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0102201761 VA
Emergency Medicine Physician 207P00000X 56179 MN Primary

Addresses

Primary practice location

407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950

Mailing address

Essentia Health Duluth Clinic SSB-5
400 E Third Street
Duluth, MN 55805-1951
Phone (218) 786-3146

Other identifiers 3

IdentifierTypeStateIssuer
1669442406MedicaidMN
1669442406MedicaidMI
1669442406MedicaidWI

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
I20130725000032 MN Practitioner - Emergency Medicine 3375792823 Reassigns benefits to 9 organizations
I20130923000139 WI Practitioner - Emergency Medicine 3375792823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essentia Health Virginia LLCGroup PAC ID 7810149002, 64 clinicians

Practice addresses (Care Compare)

901 9TH St N
Virginia, MN 55792-2325
Phone (218) 741-3340

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56179MNMDEmergency Medicine Physician
0102201761VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Medical Center CurrentSince Jul 22, 2013 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Medical Center CurrentSince Jul 22, 2013 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Essentia Health Moose Lake CurrentSince Jan 18, 2021 Accepting new patients
Essentia Health Moose Lake CurrentSince Jan 18, 2021 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
Northern Pines Medical Center CurrentSince Jan 1, 2026 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jul 22, 2013 Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Northern Pines Medical Center CurrentSince Jul 22, 2013 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Jul 22, 2013 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Jul 22, 2013 Accepting new patients
Pine Medical Center CurrentSince Jul 22, 2013 Accepting new patients
St Marys Medical Center CurrentSince Jul 22, 2013 Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

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

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

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

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

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

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

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1669442406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESSENTIA HEALTH DULUTH CLINIC SSB-5",
            "address_2": "400 E THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "address_2": "ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLST",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102201761",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "56179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669442406",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669442406",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669442406",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.