Emily Mammenga, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

77626 Issued in AZ

Practice address

1895 N Jasper Dr Ste 3
Flagstaff, AZ 86001-1632

Phone

(289) 138-8009

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, SD, AZ3 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 3

Specialty

Psychiatry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emammenga744103@direct.centracare.com

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.

• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment Care Compare group NPD
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment Care Compare group NPD
• Carris Health LLC

  • Emergency Medicine Physician
  • Willmar, MN
  • NPI 1134632680

  Psychiatry

  Medicare reassignment NPD
• Centracare Health System-NR LLC

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874
  Medicare reassignment NPD
• Northern Arizona Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Avera McKennan

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1013980598
  NPD
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  NPD
• Carris Health LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1427684612
  NPD
• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  NPD
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  NPD

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

• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1245810217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "ATTN: PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 N JASPER DR STE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011632",
            "telephone_number": "289-138-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMENGA",
        "first_name": "EMILY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "74559",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "77626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Patrick Mahon, PT, DPT, CSCS
• Peggy Mary Mahon, P.T, D.P.T.
• Eamonn M Mahoney, M.D.
• Katherine Ann Mahosky, M.S. CCC-SLP
• Joshua Makela, PA-C
• Melissa Brown Mann, LPC
• Russell Rolison Mann, MA
• Brenda Faye Manthei
• James Cory Manton, PT
• Sarah Marchant, RDMS, RVT

• Psychiatry Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.