Individual provider Active NPI

Robin Javaherian, M.D.

  • Family Medicine Physician
  • Mankato, MN
National Provider Identifier
1083803910
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51724 Issued in MN
Practice address
1230 E Main St
Mankato, MN 56001-5066
Phone
(507) 625-1811
NPI assigned
Oct 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51724 MN Primary

Addresses

Primary practice location

1230 E Main St
Mankato, MN 56001-5066

Mailing address

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 625-1811

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000594 MN Practitioner - Family Practice 2264585553 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD Family Medicine CurrentSince May 12, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Family Medicine CurrentSince Jul 18, 2024 Accepting new patients
Rural Health Care, Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Rural Health Care, Inc CurrentSince Jul 1, 2024 Accepting new patients
Avera McKennan CurrentSince Jul 18, 2024 Accepting new patients

Locations

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

300 S Bruce St
Ste 100
Marshall, MN 56258

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921

Interoperability endpoints

  • Direct secure messaging: robin.javaherian@avera.sdhealthlink.net

Organizations & group practices 6

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1083803910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015066",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015066",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVAHERIAN",
        "first_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "51724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.