Individual provider Active NPI

Michael B Ishitani, M.D.

  • Surgical Critical Care Physician
  • Rochester, MN
National Provider Identifier
1366420564
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
41932 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 56304-020 WI
Surgery Physician 208600000X 41932 MN
Surgical Critical Care Physician 2086S0102X 41932 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250918002484 IA Practitioner - General Surgery 8325183486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Vanderbilt University School of Medicine, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1776 W Lakes Pkwy
West Des Moines, IA 50266-8378

PO Box
Kansas City, MO 64184

PO Box
Suite 843151
Kansas City, MO 64184-3151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56304-020WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Aug 25, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Central Iowa Hospital Corporation CurrentSince Aug 25, 2025 Accepting new patients
Mayo Clinic CurrentSince Mar 3, 2012 Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients
Mayo Clinic CurrentSince Jul 1, 1998 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 1998 Accepting new patients
Mayo Clinic Hospital-Rochester Past Accepting new patients

Locations

13400 E Shea Blvd
Scottsdale, AZ 85259

1206 Pleasant St
#2
Des Moines, IA 50309
Phone (515) 241-6465

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

2409 Stout Rd
Menomonie, WI 54751
Phone (715) 231-3937

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1366420564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHITANI",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "56304-020",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "41932",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MN",
            "license": "41932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.