NPIMap

Individual provider Active NPI

Sandeep Kalola, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1922271857
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53043 Issued in MN
Practice address
3809 42ND Ave S
Minneapolis, MN 55406-3503
Phone
(612) 721-6261
NPI assigned
Apr 11, 2008
Last updated
Sep 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53043 MN Primary

Addresses

Primary practice location

3809 42ND Ave S
Minneapolis, MN 55406-3503

Mailing address

3809 42ND Ave S
Minneapolis, MN 55406-3503
Phone (612) 721-6261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000712 MN Practitioner - Family Practice 2860661287 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

2020 E 28TH St
Minneapolis, MN 55407-1394
Phone (612) 333-0770

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 11, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 11, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Apr 24, 2017 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Aug 12, 2011 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Clinics CurrentSince Aug 12, 2011 Accepting new patients
Fairview Express Care Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Fairview Health Services CurrentSince Aug 1, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

3809 42nd Ave S
Minneapolis, MN 55406
Phone (612) 407-7213

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

5366 386th St NE
North Branch, MN 55056
Phone (651) 674-6800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: skalola41909@fairview.direct-ci.com

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1922271857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063503",
            "telephone_number": "612-721-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063503",
            "telephone_number": "612-721-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOLA",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.