Pain Centers of Minnesota-Mankato, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN CENTERS OF MINNESOTA-MANKATO, LLC

Practice address

1400 E Madison Ave
Mankato, MN 56001-5473

Phone

(800) 657-6944

NPI assigned

Jun 4, 2010

Last updated

Jun 4, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

MANKATO CLINIC, LTDAs reported in NPPES

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

Authorized official

Name

Steve Hatkin

Title

Chief Financial Officer

Phone

(507) 389-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Listed as

Pain Centers of Minnesotamankato LLCCCN 24C0001073

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Blue Earth Medical Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029

  Member Of

  NPD member

Locations

Interoperability endpoints

• FHIR API: https://mcfhir.mankatoclinic.com/R4/open-R4

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Marie Ludvik, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Mankato, MN
  • NPI 1801780499
  Medicare reassignment NPD
• Elizabeth R Evers, PA

  • Physician Assistant
  • Mankato, MN
  • NPI 1740568922
  Medicare reassignment
• Lon T Knudson, MD

  • Pediatrics Physician
  • Saint Peter, MN
  • NPI 1134107147
  NPD (past)

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1396065082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "800-657-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF MINNESOTA-MANKATO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANKATO CLINIC, LTD",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "HATKIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-389-8500"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanna Lynne Padilla, RD, LD
• Abigail Christine Page
• Eric Alan Page, D.D.S.
• Sarah Page, DC
• Megan R Pahl, LPCC
• Abby Jo Palmer
• Randall Keith Palmer, M.ED, A.T.C.
• Shana Diane Palmer, ARNP
• Krishna M. Pamulapati, M.D.
• Malati V Pamulapati, MD

• Ambulatory Surgical Clinic/Center in Mankato, MN
• Providers in Mankato, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.