Mandalyn J Mills, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2022016390 Issued in MO

Practice address

802 N Riverside Rd Ste G50
Saint Joseph, MO 64507-2510

Phone

(816) 671-4888

Fax

(816) 671-4890

NPI assigned

Jun 27, 2017

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

Other names 1

• Mandalyn J Kautz Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

General Surgery

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Merit-based Incentive Payment System (MIPS)

Final score

84.76 of 100Reported as group

Quality

74.35

Promoting interoperability

100

Improvement activities

40

Cost

74.85

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmills28277@mosaichealthsystem.direct-ci.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.

• Heartland Regional Medical Center

  • General Practice Physician
  • Saint Joseph, MO
  • NPI 1477575405
  Medicare reassignment Care Compare group NPD
• Mosaic Medical Center - Maryville

  • Specialist
  • Maryville, MO
  • NPI 1184189797

  Surgery

  Medicare reassignment NPD
• Heartland Regional Medical Center

  • General Practice Physician
  • Saint Joseph, MO
  • NPI 1538200357

  Surgery

  NPD
• Heartland Regional Medical Center

  • Rehabilitation Hospital Unit
  • Saint Joseph, MO
  • NPI 1841385093
  NPD
• Mosaic Medical Center - Maryville

  • Psychiatric Hospital Unit
  • Maryville, MO
  • NPI 1477027803
  NPD
• Heartland Regional Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  NPD (past)
• Mosaic Medical Center - Maryville

  • Rural Health Clinic/Center
  • Maryville, MO
  • NPI 1821562265
  NPD (past)

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

• Heartland Regional Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  Care Compare affiliation

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1548780844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063512",
            "telephone_number": "816-671-4888",
            "fax_number": "816-671-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N RIVERSIDE RD STE G50",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072510",
            "telephone_number": "816-671-4888",
            "fax_number": "816-671-4890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "49519",
            "country_code": "US",
            "telephone_number": "616-252-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLS",
        "first_name": "MANDALYN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101023019",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2022016390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDALYN",
            "last_name": "KAUTZ",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Miller, LCSW
• Nichole Miller
• Peggy Sue Miller
• Sarah Ann Miller
• Tina Miller, FNP-BC
• Sara Mills, BSPHARM, RPH
• Rebecca D. Millsap, D.C.
• Kyle A. Milson, D.D.S.
• Mint Dental St. Joseph
• Missouri CVS Pharmacy LLC

• Surgery Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.