Individual provider Active NPI

Eric Ryan Pease, DO, MBA

  • Psychiatry Physician
  • Rochester, MN
National Provider Identifier
1922539634
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
64165 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 70131-21 WI
Child & Adolescent Psychiatry Physician 2084P0804X 64165 MN
Child & Adolescent Psychiatry Physician 2084P0804X 70131-21 WI
Psychiatry Physician 2084P0800X 64165 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address epease139225@ehrdirect.mayoclinicmsg.org

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
I20180806002731 MN Practitioner - Psychiatry 3779855291 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Business Administration

State licenses

LicenseStateTypeSpecialty
28331MNMDClinical Social Worker
70131-21WIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 29, 2020 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 29, 2020 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jun 29, 2020 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic CurrentSince Jul 5, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 29, 2020 Accepting new patients
Mayo Clinic CurrentSince Jul 5, 2018 Accepting new patients
Mayo Clinic Hospital-Rochester Past Accepting new patients

Locations

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

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

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

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Interoperability endpoints

  • Direct secure messaging: epease139225@ehrdirect.mayoclinicmsg.org

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1922539634",
    "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",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASE",
        "first_name": "ERIC",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "70131-21",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "64165",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "70131-21",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "64165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epease139225@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"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.