KINGSLEY IHEASIRIM (MD) – Internal Medicine Physician, NPI 1083697684

KINGSLEY IHEASIRIM (MD) is a healthcare provider. based in Mankato, Minnesota. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 46210 (MN). The NPI Number for KINGSLEY IHEASIRIM (MD) is 1083697684

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
KINGSLEY IHEASIRIM (MD)
NPI
1083697684
Phone
(507) 389-4700
Address
1015 Marsh St
Enumeration Date
29 November 2005
Last Update Date
18 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5076254031
Graduation Year
1994 (32 years ago)
PAC ID
4183520679
Group Practice PAC ID
4688585771
Professional Enrollment ID
I20031208000231
Address ID
MN560014752MA1025XSTXX300
Telehealth
Yes

Contacts

Secure Messaging
kiheasirim90267@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

3,636 INTERNAL MEDICINE in MN

Provider Addresses for KINGSLEY IHEASIRIM (MD)

  • 1015 Marsh St

    Mankato, MN 560015294

    Phone: (507) 389-4700

    Type: Location

  • Mayo Clinic Health System, 1025, Marsh Street, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States

    MANKATO, MN 560014752

    Phone: (507) 625-4031

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2003-12-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20031208000231IInternal MedicineMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99211Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional923179$0
99215Established patient office or other outpatient visit, 40-54 minutes365193$0
99214Established patient office or other outpatient visit, 30-39 minutes11894$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes9940$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit5252$0
View full utilization report →

Insurance plans in this area (ZIP 56001)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688585771View full group profile
NameSpecialtyState
Nurse PractitionerTN
Family PracticeMN
-MN
-MN
Certified Registered Nurse Anesthetist (Crna)MN
Family PracticeMN
Internal MedicineONTARIO
Nurse PractitionerMN
Family PracticeMN
Family PracticeAR

Reviews

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Frequently asked questions

Is KINGSLEY IHEASIRIM (MD) listed with a National Provider Identifier?
Yes — KINGSLEY IHEASIRIM (MD) has NPI 1083697684 on file in the registry.
Active or inactive — what applies to KINGSLEY IHEASIRIM (MD)?
You should see KINGSLEY IHEASIRIM (MD) as active in CMS-hosted NPPES data.
What area of care is associated with KINGSLEY IHEASIRIM (MD)?
KINGSLEY IHEASIRIM (MD)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with KINGSLEY IHEASIRIM (MD)?
Directory geography for KINGSLEY IHEASIRIM (MD) centers on Mankato, Minnesota.
Can I trust this NPI listing for KINGSLEY IHEASIRIM (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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