Active NPI
Emily Rose Bastyr, D.O.
- Family Medicine Physician
- Mankato, MN
National Provider Identifier
1093169682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 62472
- Practice address
- 101 Martin Luther King Dr
Mankato, MN 56001-6460 - Phone
- (507) 385-6500
- Fax
- (507) 385-6510
- NPI assigned
- Apr 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 62472 | MN | Primary |
| Family Medicine Physician | 207Q00000X | 207Q0000X | MN |
Addresses
Primary practice location
101 Martin Luther King Dr
Mankato, MN 56001-6460
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000
Other practice location 1
1217 8th St N
New Ulm, MN 56073-1552
Phone (507) 217-5000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1324 5TH St N
New Ulm, MN 56073-1514
Phone (507) 217-5000
Hospital & facility affiliations
- Allina Health Home Health
- New Ulm Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 11 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207Q0000X | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Single Specialty | Current | Accepting new patients |
| Allina Health System | Single Specialty | Current | Accepting new patients |
| Allina Health System | Single Specialty | Current | Accepting new patients |
| Allina Health System | Family Medicine | Past | Accepting new patients |
Locations
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
1217 8th St N
New Ulm, MN 56073
Phone (507) 217-5000
1324 5th St N
New Ulm, MN 56073
Phone (507) 217-5000
Interoperability endpoints
- ebastyr294809@excellian.direct.allina.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Minneapolis, MN
- NPI 1184661894
-
- Home Health Agency
- Minneapolis, MN
- NPI 1316985039
-
- Substance Use Disorder Rehabilitation Hospital Unit
- New Ulm, MN
- NPI 1346437720
-
- Critical Access Hospital
- New Ulm, MN
- NPI 1558328435
-
- Home Health Agency
- Minneapolis, MN
- NPI 1831909134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1093169682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MARTIN LUTHER KING DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016460",
"telephone_number": "507-385-6500",
"fax_number": "507-385-6510"
}
],
"practiceLocations": [
{
"address_1": "1217 8th St N",
"address_purpose": "LOCATION",
"city": "New Ulm",
"state": "MN",
"postal_code": "560731552",
"country_code": "US",
"telephone_number": "507-217-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASTYR",
"first_name": "EMILY",
"middle_name": "ROSE",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-20",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "MN",
"license": "62472",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "207Q0000X",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.