Individual provider Active NPI

Mary Kathryn Smentek, MD

  • Pediatrics Physician
  • Mankato, MN
National Provider Identifier
1801878509
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
49051 Issued in MN
Practice address
1230 E Main St
Mankato Clinic
Mankato, MN 56002-8674
Phone
(507) 625-1811
NPI assigned
Nov 17, 2005
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49051 MN Primary

Addresses

Primary practice location

1230 E Main St
Mankato Clinic
Mankato, MN 56002-8674

Mailing address

PO Box 8674
1230 E Main St Mankato Clinic LTD
Mankato, MN 56002-8674
Phone (507) 625-1811

Other identifiers 9

IdentifierTypeStateIssuer
135991OtherMNUCARE
284OtherMNAMERICAS PPO
NA2951049098OtherMNPREFERRED ONE
0763177MedicaidIA
277140100MedicaidMN
HP75350OtherMNHEALTH PARTNERS
001432575MedicaidCT
12 03867OtherMNMEDICA
295C2SMOtherMNBCBS

Other names 1

  • Mary Donohoe Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marysmentek@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000164 MN Practitioner - Pediatric Medicine 0941239362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD Pediatrics CurrentSince Sep 1, 2010 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

1421 Premier Dr
Mankato, MN 56001
Phone (507) 385-4000

Interoperability endpoints

  • Direct secure messaging: marysmentek@mklt.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1801878509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674",
            "address_2": "1230 E MAIN ST MANKATO CLINIC LTD",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "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",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMENTEK",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "49051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "135991",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAS PPO",
            "identifier": "284",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA2951049098",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0763177",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277140100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP75350",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001432575",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "12 03867",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "295C2SM",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marysmentek@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": [
        {
            "first_name": "MARY",
            "last_name": "DONOHOE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.