Kingsley Iheasirim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46210 Issued in MN

Practice address

1025 Marsh St
Mankato, MN 56001-4752

Phone

(507) 625-4031

NPI assigned

Nov 29, 2005

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

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Health Care Inc Home health agency, Golden Valley, MN, CCN 248037
• Good Samaritan Society Home Care St Peter Home health agency, Saint Peter, MN, CCN 248084
• Ecumen Home Care-Pathstone Home health agency, Mankato, MN, CCN 247224
• Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
• STCH South Central MN Opco LLC Hospice, Mankato, MN, CCN 241503
• Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093
• Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043
• Mayo Clinic Health System - Waseca Hospital, Waseca, MN, CCN 241345
• Mayo Clinic Health System St. James Hospital, St James, MN, CCN 241333
• Mayo Clinic Health System - Fairmont Hospital, Fairmont, MN, CCN 240166

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kiheasirim90267@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Fairmont

  • Multi-Specialty Clinic/Center
  • Fairmont, MN
  • NPI 1366410862
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD (past)
• Mayo Clinic Health System-Southwest Minnesota Region

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adara Home Health, Inc.

  • Home Health Agency
  • Buffalo, MN
  • NPI 1063420198
  Care Compare affiliation
• Ecumen

  • Home Health Agency
  • Mankato, MN
  • NPI 1235270539
  Care Compare affiliation
• Home Health Care, Incorporated

  • Home Health Registered Nurse
  • Golden Valley, MN
  • NPI 1255440061

  Home health agency

  Care Compare affiliation
• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499
  Care Compare affiliation
• Mayo Clinic Health System-Southeast Minnesota Region

  • General Acute Care Hospital
  • Albert Lea, MN
  • NPI 1346258100
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • Critical Access Hospital
  • Waseca, MN
  • NPI 1740256668
  Care Compare affiliation
• Mayo Clinic Health System-St James

  • Critical Access Hospital
  • Saint James, MN
  • NPI 1639198732
  Care Compare affiliation
• STCH South Central MN Opco LLC

  • Community Based Hospice Care Agency
  • Mankato, MN
  • NPI 1619786852
  Care Compare affiliation
• The Evangelical Lutheran Good Samaritan Society

  • Home Health Agency
  • Saint Peter, MN
  • NPI 1497738520
  Care Compare affiliation

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1083697684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Marsh St",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560015294",
            "country_code": "US",
            "telephone_number": "507-389-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHEASIRIM",
        "first_name": "KINGSLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "46210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kiheasirim90267@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hy-Vee Inc
• Stephanie Lynn Hylla, L.AC.
• Mohamed A Ibrahim
• Sagal Igalle
• Lucia Iglesias Torrubiano
• Kenneth Ildefonso Jr., A.T.R
• Iowa Hearing Associates LLC
• Mohammad Saiful Islam, DDS PHD
• Nataline Ismail
• Ahmed Issa, MD

• Internal Medicine Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.