Active NPI
McKayla Mary Vliem, MD
- Pediatrics Physician
- Rochester, MN
National Provider Identifier
1629918198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 36046
- Practice address
- 200 1St St. S.W.
Rochester, MN 55905 - Phone
- (507) 284-2511
- NPI assigned
- Apr 1, 2026
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 36046 | MN | Primary |
Addresses
Primary practice location
200 1St St. S.W.
Rochester, MN 55905
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20260520003090 | MN | Order and Referring Only - Pediatric Medicine | 0244709046 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36046 | MN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1629918198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860912",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860912",
"telephone_number": "507-284-2511",
"fax_number": "507-284-0702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST. S.W.",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55905",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VLIEM",
"first_name": "MCKAYLA",
"middle_name": "MARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-01",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "36046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.