Active NPI
Sheila R Ruschmeyer, MD
- Pediatrics Physician
- Mankato, MN
National Provider Identifier
1750360772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 39422
- Practice address
- 1230 E Main St
Mankato Clinic at Main Street
Mankato, MN 56001-5066 - Phone
- (507) 625-1811
- NPI assigned
- Jan 10, 2006
- 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 | 39422 | MN | Primary |
Addresses
Primary practice location
1230 E Main St
Mankato Clinic at Main Street
Mankato, MN 56001-5066
Mailing address
1230 E Main St
PO Box 8674
Mankato, MN 56001-5066
Phone (507) 625-1811
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 848526700 | Medicaid | MN | |
| 0580704 | Medicaid | IA | |
| 41084933956001C110 | Other | CHAMPUS | |
| HP29361 | Other | MN | HEALTH PARTNERS |
| 117686 | Other | MN | UCARE |
| 41B80RU | Other | MN | BCBS |
| NA2951023859 | Other | MN | PREFERRED ONE |
| 1201494 | Other | MN | MEDICA |
| 1645201 | Other | MN | AMERICAS PPO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sheilaruschmeyer@mklt.allscriptsdirect.net | Direct |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mankato Clinic LTD | Pediatrics | Current | Accepting new patients |
Locations
1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502
1421 Premier Dr
Mankato, MN 56001
Phone (507) 385-4000
Organizations & group practices 1
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": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1750360772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "PO BOX 8674",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "MANKATO CLINIC AT MAIN STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSCHMEYER",
"first_name": "SHEILA",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "39422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "848526700",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0580704",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "41084933956001C110",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP29361",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "117686",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "41B80RU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA2951023859",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1201494",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "1645201",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sheilaruschmeyer@mklt.allscriptsdirect.net",
"affiliation": "N",
"endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1421 Premier Dr",
"city": "Mankato",
"state": "MN",
"country_code": "US",
"postal_code": "560016076",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Jul 15, 2020; 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.