DR. JOEL DAVID KOLMODIN MD
NPI 1295051407
Orthopaedic Surgery - Pediatric Orthopaedic Surgery in Duluth, MN

NPI Status: Active since April 13, 2010

Contact Information

ESSENTIA HEALTH DULUTH CLINIC
400 E 3RD ST
DULUTH, MN
ZIP 55805
Phone: (218) 786-8364

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  • Individual
  • Male
  • Years of Experience 16
  • Orthopaedic Surgery
  • Pediatric Orthopaedic Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOEL KOLMODIN

This page provides the complete NPI Profile along with additional information for Joel Kolmodin, a provider established in Duluth, Minnesota with a medical specialization in Orthopaedic Surgery, focusing in pediatric orthopaedic surgery and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1295051407 assigned on April 2010. The practitioner's primary taxonomy code is 207XP3100X with license number 35.128965 (OH). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1295051407
Provider Name
DR. JOEL DAVID KOLMODIN MD
Gender
Male
Entity Type
Individual
Location Address
ESSENTIA HEALTH DULUTH CLINIC 400 E 3RD ST DULUTH, MN 55805
Location Phone
(218) 786-8364
Mailing Address
3166 WASHINGTON BLVD CLEVELAND HEIGHTS, OH 44118
Mailing Phone
(616) 405-7040
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
04-13-2010
Last Update Date
03-17-2018
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Location Map

Secondary Locations

  • 9500 Euclid Ave
    Cleveland, OH 44195
    (616) 405-7040

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery Pediatric Orthopaedic Surgery

Taxonomy Code
207XP3100X
Type
Allopathic & Osteopathic Physicians
License No.
35.128965
License State
OH
Taxonomy Description
An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Atlas $1,000 Gold - PPO
  • Atlas $1,500 Standard Gold - PPO
  • Atlas $2,650 Plus Silver - PPO
  • Atlas $3,500 HSA Silver - PPO
  • Atlas $5,000 Standard Silver - PPO
  • Atlas $6,500 Plus Bronze - PPO
  • Atlas $7,500 Standard Bronze - PPO
  • Atlas $8,200 HSA Bronze - PPO
  • Atlas $9,200 Catastrophic - PPO
  • Robin Oak $1,000 Gold - PPO
  • Robin Oak $1,500 Standard Gold - PPO
  • Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Bronze Share - HMO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - HMO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Share - HMO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Gold Standard - HMO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Share - HMO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Essentia Choice Care with Medica Silver Standard - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,000 - PPO
  • Sanford Individual Simplicity $7,100 HSA Qualified - PPO
  • Sanford Individual Simplicity $9,200 - PPO
  • Sanford Individual Simplicity Standardized $1,500 - PPO
  • Sanford Individual Simplicity Standardized $5,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • Premier $1,500 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,100 HDHP - HMO
  • Premier $5,000 - 40% - HMO
  • Premier $6,200 HDHP - HMO
  • Premier $7,500 - HMO
  • Premier $9,200 - HMO
  • Premier Protection - HMO
  • Select $1,500 - 25% - EPO
  • Select $3,500 - 30% - EPO
  • Select $4,100 HDHP - EPO
  • Select $5,000 - 40% - EPO
  • Select $6,200 HDHP - EPO
  • Select $7,500 - EPO
  • Select $9,200 - EPO
  • Select Protection - EPO
  • Premier HMO $1,500 - 30% - HMO
  • Premier HMO $2,500 - 20% Copay - HMO
  • Premier HMO $3,300 - 30% HDHP - HMO
  • Premier HMO $3,500 - 30% - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Joel Kolmodin is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Joel Kolmodin is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6406142751

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180329001911

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Lower limb (leg) arthroscopy (minimally invasive joint repair)

Lower limb arthroscopy is a minimally invasive procedure that allows doctors to examine and repair issues in your leg joints. It involves making small incisions through which a tiny camera and instruments are inserted. This technique can help diagnose and treat various joint problems with less pain and quicker recovery time.

This service was performed for 1-10 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Joel Kolmodin is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ESSENTIA HEALTH ST MARY'S MEDICAL CENTER402 EAST SECOND STREET
DULUTH, MN 55805
(218) 786-3574Acute Care Hospitals
ESSENTIA HEALTH DULUTH502 EAST SECOND STREET
DULUTH, MN 55805
(218) 786-2652Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1295051407
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2218505240
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 8 + 5 + 0 + 5 + 2 + 4 + 0 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1295051407 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821239161DR. ANDREW GEORGE KEENAN M.D.
Individual
HospitalistESSENTIA HEALTH DULUTH CLINIC 400 EAST THIRD STREET
DULUTH, MN 55805
(218) 786-8364
1164874699 GRETCHEN GREENWELL KEHOE
Individual
Physician AssistantESSENTIA HEALTH DULUTH CLINIC 400 EAST THIRD STREET
DULUTH, MN 55805
(218) 786-8364
1437525417MRS. SARAH MARIE LACH PA-C
Individual
Physician AssistantESSENTIA HEALTH DULUTH CLINIC 400 EAST THIRD STREET
DULUTH, MN 55805
(218) 786-8364
1962805549 TERRI HALVERSON
Individual
Nurse Practitioner (Obstetrics & Gynecology)ESSENTIA HEALTH DULUTH CLINIC 400 EAST THIRD STREET
DULUTH, MN 55805
(218) 786-8364
1689075012 CHERYL LAGERGREN
Individual
Social Worker (Clinical)ESSENTIA HEALTH DULUTH CLINIC 400 EAST THRID STREET
DULUTH, MN 55805
(218) 786-8364

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295051407, enumerated in the NPI registry as an "individual" on April 13, 2010

The provider is located at Essentia Health Duluth Clinic 400 E 3rd St Duluth, Mn 55805 and the phone number is (218) 786-8364

The provider's speciality is Orthopaedic Surgery with taxonomy code 207XP3100X with a focus in Pediatric Orthopaedic Surgery

The provider has more than 16 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, HealthPartners,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Lower limb (leg) arthroscopy (minimally invasive joint repair).

The practitioner is affiliated to the following hospital(s): ESSENTIA HEALTH ST MARY'S MEDICAL CENTER and ESSENTIA HEALTH DULUTH. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 13, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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