Individual provider Active NPI

Michael R Gartner, MD

  • Emergency Medicine Physician
  • Mankato, MN
National Provider Identifier
1205835469
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
56163 Issued in MN
Practice address
Mayo Clinic Health System
1025
Mankato, MN 56001-5600
Phone
(507) 624-4031
Fax
(507) 624-4031
NPI assigned
Jul 20, 2005
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 051637 MI
Emergency Medicine Physician 207P00000X 56163 MN Primary
Family Medicine Physician 207Q00000X 4301051637 MI
Family Medicine Physician 207Q00000X 432455 KS

Addresses

Primary practice location

Mayo Clinic Health System
1025
Mankato, MN 56001-5600

Mailing address

Mayo Clinic Health System
1025 Marsh St
Mankato, MN 56001
Phone (507) 625-4031

Other practice location 1

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 962-2239

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

State licenses

LicenseStateTypeSpecialty
051637MIMDEmergency Medicine Physician
432455KSMDFamily Medicine Physician
4301051637MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Runway Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Thunder Bay Emergency Physicians PC Emergency Medicine Past Accepting new patients
Emergency Services, PA Emergency Medicine Past Accepting new patients

Organizations & group practices 3

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1205835469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAYO CLINIC HEALTH SYSTEM",
            "address_2": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAYO CLINIC HEALTH SYSTEM",
            "address_2": "1025",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015600",
            "telephone_number": "507-624-4031",
            "fax_number": "507-624-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Hillside St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672144910",
            "country_code": "US",
            "telephone_number": "316-962-2239",
            "fax_number": "316-962-2668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "051637",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "56163",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301051637",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "432455",
            "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 Jun 11, 2019; 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.