Individual provider Active NPI

Ryan Casper, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mankato, MN
National Provider Identifier
1083077259
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D14356 Issued in MN
Practice address
1990 Premier Dr
Mankato, MN 56001-5900
Phone
(507) 625-9330
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D14356 MN Primary

Addresses

Primary practice location

1990 Premier Dr
Mankato, MN 56001-5900

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200708002594 MN Practitioner - Dentist 6901190990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Oral and Maxillofacial Surgery, P.a.Group PAC ID 7416988209, 3 clinicians

Practice addresses (Care Compare)

1990 Premier Dr
Mankato, MN 56001-5900
Phone (507) 625-9330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14356MNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Oral and Maxillofacial Surgery, P.a. Oral and Maxillofacial Surgery CurrentSince Jul 1, 2020 Accepting new patients

Locations

1990 Premier Dr
Mankato, MN 56001
Phone (507) 625-9330

2717 Superior Dr NW
Ste B
Rochester, MN 55901
Phone (507) 281-5820

Interoperability endpoints

  • Direct secure messaging: rcasper220069@direct.emplifyhealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1083077259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 PREMIER DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015900",
            "telephone_number": "507-625-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASPER",
        "first_name": "RYAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D14356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.