Chad M Kissela, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

41191 Issued in MN

Practice address

1406 6TH Ave N
Saint Cloud, MN 56303-1900

Phone

(320) 251-2700

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Anesthesiology

Education

University of Wisconsin School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
• Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckissela1373@direct.centracare.com

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.

• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  Medicare reassignment Care Compare group NPD
• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264
  Medicare reassignment Care Compare group NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1003339789
  NPD
• Centracare Clinic

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Centracare Clinic Southwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1912664889
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carris Health LLC

  • Infusion Therapy Clinic/Center
  • Willmar, MN
  • NPI 1124657150

  Hospital

  Care Compare affiliation
• Carris Health LLC

  • General Acute Care Hospital
  • Willmar, MN
  • NPI 1407367030
  Care Compare affiliation
• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1912998584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563020725",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELA",
        "first_name": "CHAD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "41191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "655314100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckissela1373@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ckissela1373@direct.centracare.com",
            "address_1": "1406 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn M Kinzer
• Jody Ann Kirchner, MSW LICSW
• Jean Kay Kirk, APRN CNP
• Makenzie Donnae Kirkendall
• Laura Marie Kirt, LPN
• Katherine Klaphake
• Wendy S Klebs, CMT
• Nathaniel Kleene, RBT
• Ann Klein
• Barbara L Klein, MS LICSW

• Anesthesiology Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.