Individual provider Active NPI

Graciela Maldonado

  • Emergency Medicine Physician
  • Austin, MN
National Provider Identifier
1831650852
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
74254 Issued in MN
Practice address
1000 1St Dr NW
Austin, MN 55912-2941
Phone
(507) 433-7351
NPI assigned
Mar 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30266 MN
Emergency Medicine Physician 207P00000X 74254 MN Primary

Addresses

Primary practice location

1000 1St Dr NW
Austin, MN 55912-2941

Mailing address

200 1St St SW
Rochester, MN 55905-0001

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gmaldonado425130@ehrdirect.mayoclinicmsg.org
Direct Messaging Address gmaldonado425130@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230607000567 MN Practitioner - Emergency Medicine 2466787650 Reassigns benefits to 4 organizations
I20240716001151 MA Practitioner - Emergency Medicine 2466787650 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30266MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince May 23, 2023 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince May 23, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince May 23, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Brigham & Womens Physicians Organization Inc Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: maldonado.graciela.mgh@direct.partners.masshiway.net

Organizations & group practices 9

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": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1831650852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "GRACIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "30266",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "74254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmaldonado425130@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmaldonado425130@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1000 1st Dr NW",
            "city": "Austin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559122941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, MN

Sources for this page

Verify at the official NPI Registry.