NPIMap

Organization Active NPI

Mayo Clinic Health System-Southwest Minnesota Region

Doing business as Mayo Clinic Health System-Waseca

  • Medicare Defined Swing Bed Hospital Unit
  • Waseca, MN
National Provider Identifier
1942277769
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION
Doing business as
Mayo Clinic Health System-Waseca
Practice address
501 North State Street
Waseca, MN 56093
Phone
(507) 835-1210
Fax
(507) 781-8945
NPI assigned
Mar 1, 2006
Last updated
Apr 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Morris Miller
Title
Cfo
Phone
(507) 594-2646

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary
Critical Access Hospital 282NC0060X 323805 MN

Addresses

Primary practice location

501 North State Street
Waseca, MN 56093

Mailing address

501 State St N
Waseca, MN 56093-2811
Phone (507) 835-1210

Other identifiers 1

IdentifierTypeStateIssuer
1710EWAOtherMNBCBS

Other names 1

  • Mayo Clinic Health System-Waseca Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171128002974 MN Part A Provider - Critical Access Hospital 4688585771 Practice locations: Waseca, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942277769. Details of each certification follow.

Hospital certification: CCN 24Z345

Legal name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION
Doing business as
MAYO CLINIC HEALTH SYSTEM-WASECA
Organization structure
CorporationNon-profit
Incorporated
Dec 27, 1968 in MN
Enrollment address
501 State St N
Waseca, MN 56093-2811
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Riverview Clinic10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Member organizations 11

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Meggan Luevano Individual Corporate DirectorBoard Member Mar 25, 2026
Dena Keilman Individual Corporate DirectorBoard Member Jan 1, 2025
Karthik Ghosh Individual Corporate OfficerCeo, President, Chair Jan 1, 2025
Corporate DirectorBoard Member Jan 1, 2025
Travis Paul Individual Corporate OfficerSecretary & Cao Nov 1, 2021
Corporate DirectorBoard Member Jan 1, 2025
W-2 Managing EmployeeAd; Nov 1, 2021
Tara Krosch Individual Corporate DirectorBoard Member Jan 1, 2025
Mackenzie Rose Miller Individual W-2 Managing EmployeeHospital Administrator Sep 1, 2022
Mansi Kanuga Individual Corporate DirectorBoard Member Jan 1, 2025
Brian Lynch Individual Corporate DirectorBoard Member Jan 1, 2025
Taylor Beahrs Individual Corporate DirectorBoard Member Jan 1, 2025
Gokhan Anil Individual Corporate DirectorBoard Member Jan 1, 2019
Mayo Clinic Organization, Rochester, MN Corporation, Non-profit, Chain home office Operational/Managerial Control Jan 1, 2018
Brian Bartlett Individual Corporate DirectorBoard Member Jan 1, 2025
Syed Khan Individual Corporate DirectorBoard Member Jan 1, 2025
Albert Harris Individual Corporate DirectorBoard Member Jan 1, 2025
Morris Miller Individual Corporate OfficerTreasurer & Chief Financial Officer May 22, 2023
Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayo Clinic Health System-FairmontFairmont, MN, CCN 240166 Hospital Operational/Managerial Control May 23, 2011
Mayo Clinic Health System-St JamesSaint James, MN, CCN 241333 Hospital Operational/Managerial Control Jan 1, 2008
Mayo Clinic Health System-St JamesSaint James, MN, CCN 24Z333 Hospital Operational/Managerial Control Jan 1, 2008
Mayo Clinic Health System-FairmontFairmont, MN, CCN 24U166 Hospital Operational/Managerial Control May 23, 2011

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 38

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 38

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1942277769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 STATE ST N",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "560932811",
            "telephone_number": "507-835-1210",
            "fax_number": "507-781-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NORTH STATE STREET",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "56093",
            "telephone_number": "507-835-1210",
            "fax_number": "507-781-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "507-594-2646"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "323805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1710EWA",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Health System-Waseca",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waseca, MN

Sources for this page

Verify at the official NPI Registry.