NPIMap

Organization Active NPI

Mankato Anesthesia Associates LTD

  • Anesthesiology Physician
  • Mankato, MN
National Provider Identifier
1124052436
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MANKATO ANESTHESIA ASSOCIATES LTD
Practice address
1400 E Madison Ave
Ste 311
Mankato, MN 56001-5473
Phone
(507) 387-8980
Fax
(507) 387-8985
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
David J Egli, MD
Title
President
Phone
(507) 387-8980

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1400 E Madison Ave
Ste 311
Mankato, MN 56001-5473

Mailing address

PO Box 4278
Mankato, MN 56002-4278
Phone (507) 387-8980

Other identifiers 4

IdentifierTypeStateIssuer
209708700MedicaidMN
41392MAOtherBLUE SHIELD OF MN
115401OtherUCARE
2972OtherHEALTH PARTNERS

National Provider Directory

National Provider Directory

Locations

1400 Madison Ave
Ste 311
Mankato, MN 56001
Phone (507) 345-2623

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1124052436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4278",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560024278",
            "telephone_number": "507-387-8980",
            "fax_number": "507-387-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "address_2": "STE 311",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "507-387-8980",
            "fax_number": "507-387-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANKATO ANESTHESIA ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "EGLI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-387-8980",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209708700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MN",
            "identifier": "41392MA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "115401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "2972",
            "state": null
        }
    ],
    "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 11, 2017; 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.