NPIMap

Organization Active NPI

Mankato Surgical Center, L.L.C.

  • Ambulatory Surgical Clinic/Center
  • Mankato, MN
National Provider Identifier
1720161615
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
331023 Issued in MN
Legal business name
MANKATO SURGICAL CENTER, L.L.C.
Practice address
1411 Premiere Dr
Mankato, MN 56001
Phone
(507) 388-6000
Fax
(507) 388-6913
NPI assigned
Oct 23, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sara L Ebert
Title
Controller/Business Office Manager
Phone
(507) 388-6000

Member of 1

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

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Mankato Surgery CenterCCN 24C0001036
Medicare certification status
ActiveFrom the Provider of Services file

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100121000534 MN Part B Supplier - Ambulatory Surgical Center 2163564659 Receives reassigned benefits from 25 practitioners
Practice locations: Mankato, MN

National Provider Directory

National Provider Directory

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Ambulatory Surgical Clinic/Center 261QA1903X 331023 MN Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

NPPES NPI Registry

Primary practice location

1411 Premiere Dr
Mankato, MN 56001

Mailing address

1411 Premiere Dr
Mankato, MN 56001-6076
Phone (507) 388-6000

Other identifiers 6

NPPES NPI Registry
IdentifierTypeStateIssuer
7C61MAOtherFMBLUE CROSS PROVIDER NUMBE
86783OtherMNHEALTH PARTNERS PROVIDER
163458500MedicaidMN
1031138OtherMNPREFERRED ONE PROVIDER NU
170117OtherMNUCARE PROVIDER NUMBER
6800031OtherMNMEDICA PROVIDER NUMBER

Other names 1

NPPES NPI Registry
  • Mankato Surgery Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 18, 2022.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1720161615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 PREMIERE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016076",
            "telephone_number": "507-388-6000",
            "fax_number": "507-388-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 PREMIERE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-388-6000",
            "fax_number": "507-388-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANKATO SURGICAL CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CONTROLLER/BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "507-388-6000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MN",
            "license": "331023",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "7C61MA",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS PROVIDER",
            "identifier": "86783",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163458500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE PROVIDER NU",
            "identifier": "1031138",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE PROVIDER NUMBER",
            "identifier": "170117",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "6800031",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mankato Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mankato Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.