Individual provider Active NPI

Heidi Mahnken, M.D.

  • Surgery Physician
  • Columbia, MO
National Provider Identifier
1942658745
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2024037749 Issued in MO
Practice address
1601 E Broadway Ste 240
Columbia, MO 65201-8022
Phone
(573) 815-8145
Fax
(573) 815-3832
NPI assigned
Jun 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 32364 OK
Surgery Physician 208600000X 56431 KY
Surgery Physician 208600000X 2024037749 MO Primary

Addresses

Primary practice location

1601 E Broadway Ste 240
Columbia, MO 65201-8022

Mailing address

1601 E Broadway Ste 240
Columbia, MO 65201-8022
Phone (573) 815-8145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20241216003323 MO Practitioner - General Surgery 3779879234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1601 E Broadway
Suite 240
Columbia, MO 65201-8022
Phone (573) 815-8145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)23
Upper gastrointestinal (GI) endoscopy for acid reflux14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024037749MOMDSurgery Physician
32364OKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Jan 13, 2025 Accepting new patients

Locations

1601 E Broadway
Ste 240
Columbia, MO 65201
Phone (573) 815-8145

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

Interoperability endpoints

  • Direct secure messaging: hmahnken146221@direct.phhs.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1942658745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018022",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018022",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKEN",
        "first_name": "HEIDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "32364",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "56431",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2024037749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.