Active NPI
Destiny M Miller-Mancuso, M.D.
- Family Medicine Physician
- Le Mars, IA
National Provider Identifier
1306366729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R-11054
- Practice address
- 714 Lincoln St. NE
Le Mars, IA 51031-3314 - Phone
- (712) 546-3492
- Fax
- (712) 546-3352
- NPI assigned
- Jun 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-11054 | IA | Primary |
Addresses
Primary practice location
714 Lincoln St. NE
Le Mars, IA 51031-3314
Mailing address
714 Lincoln St. NE
Le Mars, IA 51031-3314
Phone (712) 546-3492
Other names 1
- Destiny M Miller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200717001077 | IA | Practitioner - Family Practice | 7911263421 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Floyd Valley Healthcare
Practice addresses (Care Compare)
714 Lincoln St NE
Le Mars, IA 51031-3314
Phone (712) 546-3338
Hospital & facility affiliations
- Floyd Valley Hospital Community Health Services
- Floyd Valley Healthcare
- St Lukes Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd Valley Healthcare | Family Medicine | Current | Accepting new patients |
| Floyd Valley Healthcare | Current | Accepting new patients | |
| Medical Associates P.C. | Family Medicine | Current | Accepting new patients |
| Floyd Valley Healthcare | Current | Accepting new patients | |
| Floyd Valley Healthcare | Current | Accepting new patients |
Locations
714 Lincoln St NE
Le Mars, IA 51031
Phone (712) 546-3338
Interoperability endpoints
- destiny.millermancuso@avera.sdhealthlink.net
Organizations & group practices 7
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.
-
- Community/Retail Pharmacy
- Le Mars, IA
- NPI 1710765433
-
- Medicare Defined Swing Bed Hospital Unit
- Le Mars, IA
- NPI 1104988294
-
- Home Health Agency
- Le Mars, IA
- NPI 1558423632
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Le Mars, IA
- NPI 1558423632
-
- General Acute Care Hospital
- Sioux City, IA
- NPI 1962594622
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1306366729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 LINCOLN ST. NE",
"city": "LE MARS",
"state": "IA",
"postal_code": "510313314",
"telephone_number": "712-546-3492",
"fax_number": "712-546-3352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 LINCOLN ST. NE",
"city": "LE MARS",
"state": "IA",
"postal_code": "510313314",
"telephone_number": "712-546-3492",
"fax_number": "712-546-3352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER-MANCUSO",
"first_name": "DESTINY",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-27",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "R-11054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DESTINY",
"last_name": "MILLER",
"middle_name": "M",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Le Mars, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.