NPIMap

Individual provider Active NPI

Jamie M Kalafatich, DO

  • Family Medicine Physician
  • Forest, VA
National Provider Identifier
1972764165
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102202308 Issued in VA
Practice address
16890 Forest Rd
Forest, VA 24551-4059
Phone
(434) 200-7210
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102202308 VA Primary
Family Medicine Physician 207Q00000X 56344 MN
Family Medicine Physician 207Q00000X 0116018762 VA

Addresses

Primary practice location

16890 Forest Rd
Forest, VA 24551-4059

Mailing address

16890 Forest Rd
Forest, VA 24551-4059
Phone (434) 200-7210

Other names 1

  • Jamie R Matherly Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkalafatich217709@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090423000551 VA Practitioner - Family PracticePractitioner - General Practice 0547318909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116018762VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Healtheast Medical Research Institute Family Medicine CurrentSince Apr 1, 2015 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Allina Health System Family Medicine CurrentSince Dec 31, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2015 Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

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

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

870 Grand Ave
Saint Paul, MN 55105
Phone (651) 326-5650

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

2900 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 471-5600

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

16890 Forest Rd
Forest, VA 24551
Phone (434) 200-7210

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

125 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 200-3908

Interoperability endpoints

  • Direct secure messaging: jkalafatich217709@excellian.direct.allina.com

Organizations & group practices 9

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.

Hospital & facility affiliations 10

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1972764165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16890 FOREST RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514059",
            "telephone_number": "434-200-7210",
            "fax_number": "434-525-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16890 FOREST RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514059",
            "telephone_number": "434-200-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAFATICH",
        "first_name": "JAMIE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202308",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "56344",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116018762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkalafatich217709@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1155 County Road E E",
            "address_2": "Suite 100",
            "city": "Vadnais Heights",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551105183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "MATHERLY",
            "middle_name": "R",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.