Prasun Mandal, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

79925 Issued in MN

Practice address

424 W Highway 5
Waconia, MN 55387-1795

Phone

(952) 442-4461

NPI assigned

Jun 18, 2021

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

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeview Clinic, LTD.Group PAC ID 6002801453, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Hospice Hospice, Waconia, MN, CCN 241567
• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmandal1044053@direct.trinity-health.org
• Direct secure messaging: pmandal889676@direct.unitypoint.org
• Direct secure messaging: prasunmandal@tv.allscriptsdirect.net

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.

• Lakeview Clinic, LTD.

  • Multi-Specialty Clinic/Center
  • Waconia, MN
  • NPI 1669599981
  Medicare reassignment Care Compare group NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923

  Family Medicine

  NPD (past)

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

• Ridgeview Medical Center

  • Community Based Hospice Care Agency
  • Waconia, MN
  • NPI 1013045350
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  Care Compare affiliation

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1205405875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461",
            "fax_number": "952-442-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110105 Pioneer Trl W",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553182680",
            "country_code": "US",
            "telephone_number": "952-556-0120",
            "fax_number": "952-556-0121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "406 Faxon Rd N",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MN",
            "postal_code": "553689507",
            "country_code": "US",
            "telephone_number": "952-467-2888",
            "fax_number": "952-467-3258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 Territorial St E",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "MN",
            "postal_code": "553889284",
            "country_code": "US",
            "telephone_number": "952-955-1921",
            "fax_number": "952-955-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDAL",
        "first_name": "PRASUN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-18",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "79925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Waconia, MN
• Providers in Waconia, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.

Verify at the official NPI Registry.