Timothy Mangold, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002420 Issued in IA

Practice address

1301 33Rd St S
Saint Cloud, MN 56301-9668

Phone

(320) 251-8181

NPI assigned

Dec 9, 2006

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Clinic 800 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tmangold576166@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

  MN

  Medicare reassignment Care Compare group
• Centracare Clinic

  • Urology Physician
  • Sartell, MN
  • NPI 1700281953
  Care Compare group NPD
• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264

  MN

  Medicare reassignment
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Joseph, MN
  • NPI 1134121759
  Care Compare group NPD (past)
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  Care Compare group NPD (past)
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Big Lake, MN
  • NPI 1013104348
  Care Compare group
• Centracare Clinic

  • Clinic/Center
  • Saint Cloud, MN
  • NPI 1164978219
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Clearwater, MN
  • NPI 1255853115
  Care Compare group
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1407858020
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • St Cloud, MN
  • NPI 1659425114
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1669994315
  Care Compare group
• Centracare Clinic

  • Primary Care Clinic/Center
  • Sartell, MN
  • NPI 1689196339
  Care Compare group

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1043370315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2557 N DODGE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522459556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 33RD ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019668",
            "telephone_number": "320-251-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2557 N Dodge St",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522459556",
            "country_code": "US",
            "telephone_number": "319-384-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGOLD",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew O'Connor Maloney, MD
• Katie Malotky, PT
• Amber Manders
• Kristen Manderschied, NP
• Madeline Mangin, MD
• Lara Jean Manikowski
• Phoutphong Manivong, DNP, ARPN, CRNA
• Mankato Home Health Care, LLC
• Kelly Manley
• Angelia Cynthia Marie Mann

• All providers in Saint Cloud, MN
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.