Active NPI
Ellison F. Kalda, MD
- Surgery Physician
- Marshall, MN
National Provider Identifier
1730153529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 1227
- Practice address
- 300 South Bruce Street
Affiliated Community Medical Centers
Marshall, MN 56258 - Phone
- (507) 532-9631
- Fax
- (507) 532-1176
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 1227 | SD | Primary |
Addresses
Primary practice location
300 South Bruce Street
Affiliated Community Medical Centers
Marshall, MN 56258
Mailing address
300 South Bruce Street
Affiliated Community Medical Centers
Marshall, MN 56258
Phone (507) 532-9631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7300700 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1227 | SD | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Institute of South Dakota, PC | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgery Physician
- Sioux Falls, SD
- NPI 1760569248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1730153529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SOUTH BRUCE STREET",
"address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"city": "MARSHALL",
"state": "MN",
"postal_code": "56258",
"telephone_number": "507-532-9631",
"fax_number": "507-532-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SOUTH BRUCE STREET",
"address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"city": "MARSHALL",
"state": "MN",
"postal_code": "56258",
"telephone_number": "507-532-9631",
"fax_number": "507-532-1176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALDA",
"first_name": "ELLISON",
"middle_name": "F.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SD",
"license": "1227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7300700",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.