Individual provider Active NPI

Abel Alfonso, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • Mankato, MN
National Provider Identifier
1174617740
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
58717 Issued in MN
Practice address
1230 E Main St
Mankato, MN 56001-8001
Phone
(507) 625-1811
NPI assigned
Oct 3, 2006
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DR.0053160 CO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0102202339 VA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 58717 MN Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X OS8831 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5101027097 MI

Addresses

Primary practice location

1230 E Main St
Mankato, MN 56001-8001

Mailing address

1230 E Main St
Mankato, MN 56001-8001
Phone (507) 625-1811

Other practice location 1

7901 S 12th St Ste 200
Portage, MI 49024-3831
Phone (269) 341-8585

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abelalfonso@mklt.allscriptsdirect.net Direct
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130906000331 NE Practitioner - Endocrinology 3476747957 Reassigns benefits to 1 organization
I20230823001134 WI Practitioner - Endocrinology 3476747957

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

611 W Francis St
200 Great Plains Health Outpatient Services
North Platte, NE 69101-0614
Phone (308) 568-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0053160COMDEndocrinology, Diabetes & Metabolism Physician
OS8831FLMDEndocrinology, Diabetes & Metabolism Physician
5101027097MIMDEndocrinology, Diabetes & Metabolism Physician
0102202339VAMDEndocrinology, Diabetes & Metabolism Physician
1024NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Endocrinology, Diabetes & Metabolism CurrentSince Apr 8, 2024 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients

Locations

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

611 W Francis St
Ste 200
North Platte, NE 69101
Phone (308) 534-9230

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1174617740",
    "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": "560018001",
            "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": "560018001",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 S 12th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490243831",
            "country_code": "US",
            "telephone_number": "269-341-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALFONSO",
        "first_name": "ABEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CO",
            "license": "DR.0053160",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0102202339",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "58717",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "OS8831",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "5101027097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abelalfonso@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1230 E Main St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560018001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.