Individual provider Active NPI

Todd Laverne Kanzenbach, M.D.

  • Family Medicine Physician
  • Mankato, MN
National Provider Identifier
1124016597
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38627 MN Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 38627 MN

Addresses

Primary practice location

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

Mailing address

600 Maywood Ave
21 Carkoski Commons
Mankato, MN 56001-6441
Phone (507) 389-1430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota State Colleges and Universities PastSince Jan 26, 2022 Accepting new patients
MN State Colleges and Universities PastSince Jan 26, 2022 Accepting new patients
Minnesota State Colleges and Universities Past Accepting new patients
Winona State University Student Health Services Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "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": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "38627",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "38627",
            "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 Oct 22, 2026; 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.