Individual provider Active NPI

Kelli Ostermann, MD

  • Pediatrics Physician
  • Winona, MN
National Provider Identifier
1801973979
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5507 Issued in SD
Practice address
855 Mankato Ave
Winona, MN 55987-4868
Phone
(507) 454-3680
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5507 SD Primary
Pediatrics Physician 208000000X 42795 WI
Pediatrics Physician 208000000X 55411 MN

Addresses

Primary practice location

855 Mankato Ave
Winona, MN 55987-4868

Mailing address

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3680

Other identifiers 1

IdentifierTypeStateIssuer
6761770MedicaidSD

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
I20081022000175 WI Practitioner - Pediatric Medicine 1355311044 Reassigns benefits to 2 organizations
I20151027003046 MN Practitioner - Pediatric Medicine 1355311044 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5507SDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Pediatrics CurrentSince Sep 16, 2010 Accepting new patients
Winona Health Services CurrentSince Nov 30, 2015 Accepting new patients
Westfields Hospital, Inc CurrentSince Aug 1, 2013 Accepting new patients
Westfields Hospital, Inc. Current Accepting new patients
Westfields Hospital, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Medical Associates of the Black Hillc, LLC. Pediatrics Past Accepting new patients
Winona Health Services Past Accepting new patients

Locations

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

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

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1801973979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERMANN",
        "first_name": "KELLI",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "5507",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "42795",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "55411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6761770",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.