Todd Laverne Kanzenbach, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

38627 Issued in MN

Practice address

21 Carkoski Commons
Minnesota State University, Mankato
Mankato, MN 56001-6030

Phone

(507) 389-6276

Fax

(507) 389-5787

NPI assigned

Oct 11, 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Minnesota State Colleges and Universities

  • Clinic/Center
  • Bemidji, MN
  • NPI 1083881452
  NPD (past)
• Minnesota State Colleges and Universities

  • Pharmacy
  • Mankato, MN
  • NPI 1487636213
  NPD (past)
• MN State Colleges and Universities

  • Student Health Clinic/Center
  • Mankato, MN
  • NPI 1386629368
  NPD (past)
• Winona State University Student Health Services

  • Student Health Clinic/Center
  • Winona, MN
  • NPI 1700906633
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1124016597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAYWOOD AVE",
            "address_2": "21 CARKOSKI COMMONS",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016441",
            "telephone_number": "507-389-1430",
            "fax_number": "507-389-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CARKOSKI COMMONS",
            "address_2": "MINNESOTA STATE UNIVERSITY, MANKATO",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016030",
            "telephone_number": "507-389-6276",
            "fax_number": "507-389-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANZENBACH",
        "first_name": "TODD",
        "middle_name": "LAVERNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "38627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-09557",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "247M1KA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140293",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaede Kaneda
• Brielle Mae Kangas
• Mary Jo Kann
• Manpreet Kanwar, MD
• John Stephen Kanyusik, DDS, MS
• Kevin Randish Kapoor, M.D.
• Kaveh Karimnejad, M.D.
• Manasa Karumuri, M.D.
• Kato Cab, Inc.
• Kato Family Chiropractic, P.a.

• Sports Medicine (Family Medicine) Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Sports Medicine (Family Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.