JOHN A. KOLE MD
NPI 1720065360
Surgery in Grand Rapids, MN
About John A. Kole Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN A. KOLE MD (NPI 1720065360) is an individual surgery provider in Grand Rapids, Minnesota, licensed in Minnesota (37415) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Grand Itasca Clinic And Hospital, and is a graduate of Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University (1986).
NPPES Registry Identity
Specialties & Licenses
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
John A. Kole Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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.
Colonoscopy
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Hernia repair - groin (open)
Melanoma (skin cancer) excision
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery
Removal of polyps or growths of large bowel using an endoscope with mechanical snare
Upper gastrointestinal (GI) endoscopy for acid reflux
A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.
This service was performed for 51 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 18 times for 13 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 17 times for 15 patientsHernia repair in the groin area (open) is a surgical procedure to fix a bulge or protrusion, caused by internal tissues pushing through a weak spot in your abdominal wall. In this operation, a small incision is made in the groin area. The protruding tissue is then placed back into the abdomen, and the weakened area is reinforced with stitches or a mesh.
This service was performed for 15 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 14 patientsThis procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
This service was performed 27 times for 27 patientsThis procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
This service was performed 12 times for 12 patientsAn upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.
This service was performed for 22 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.45 for a new patient copayment and $17.43 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 55744 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.82
- Minimum New Patient Price $56
- Maximum New Patient Price $168.28
- Average New Patient Copayment $21.45
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.07
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.74
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $138.04
- Average Established Patient Copayment $17.43
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $34.51
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.32, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 90.32 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 93.18
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category comprises 40% of a provider's final MIPS score.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category comprises 25% of a provider's final MIPS score.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: 65.92
The Cost performance category assesses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category comprises 20% of a provider's final MIPS score.
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. John Kole is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| GRAND ITASCA CLINIC AND HOSPITAL | 1601 GOLF COURSE ROAD GRAND RAPIDS, MN 55744 | (218) 326-3401 | Acute Care Hospitals |
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
GRAND RAPIDS, MN 55744
GRAND RAPIDS, MN 55744
GRAND RAPIDS, MN 55744
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720065360, enumerated as an "individual" on December 26, 2005.
The provider is located at 1601 GOLF COURSE RD GRAND RAPIDS, MN 55744 and the phone number is (218) 326-5000.
Surgery with taxonomy code 208600000X.
The provider might be accepting Accepts: Medica, Sanford Health Plan, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
John Kole is affiliated with: GRAND ITASCA CLINIC AND HOSPITAL.
