Individual provider Active NPI

Ronald Joseph Kolegraff, M.D.

  • Surgery Physician
  • Okoboji, IA
National Provider Identifier
1891757878
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
24582 Issued in IA
Practice address
1008 Eastview Ave
Unit 8
Okoboji, IA 51355-2633
Phone
(712) 332-6001
Fax
(712) 332-6010
NPI assigned
Apr 5, 2006
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 24582 IA Primary
Phlebology Physician 202K00000X 24582 IA

Addresses

Primary practice location

1008 Eastview Ave
Unit 8
Okoboji, IA 51355-2633

Mailing address

PO Box 125
Okoboji, IA 51355-0125
Phone (712) 332-6001

Other identifiers 1

IdentifierTypeStateIssuer
0223222MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000385 IA Practitioner - General PracticePractitioner - Plastic and Reconstructive Surgery 7416050802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Plastic and Reconstructive Surgery
Education
Un of California, Irvine, College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Skin Clinics PLCGroup PAC ID 0244333532, 3 clinicians

Practice addresses (Care Compare)

3301 Hwy 71
Suite 1
Spirit Lake, IA 51360-7634
Phone (712) 332-6001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Varicose vein removal35
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24582IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Institute PC PastSince May 23, 2012 Accepting new patients

Organizations & group practices 2

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 1

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1891757878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "OKOBOJI",
            "state": "IA",
            "postal_code": "513550125",
            "telephone_number": "712-332-6001",
            "fax_number": "712-332-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 EASTVIEW AVE",
            "address_2": "UNIT 8",
            "city": "OKOBOJI",
            "state": "IA",
            "postal_code": "513552633",
            "telephone_number": "712-332-6001",
            "fax_number": "712-332-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLEGRAFF",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "24582",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IA",
            "license": "24582",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0223222",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okoboji, IA

Sources for this page

Verify at the official NPI Registry.