Provider Demographics
NPI:1215916283
Name:CLAUSS, SARAH D (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:D
Last Name:CLAUSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E MAIN ST
Mailing Address - Street 2:PO BO X 8674
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC LTD
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8674
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2016-10-25
Deactivation Date:2016-09-27
Deactivation Code:
Reactivation Date:2016-10-25
Provider Licenses
StateLicense IDTaxonomies
MN438832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1965629OtherAMERICAS PPO
41084933956001C176OtherCHAMPUS
IA0559021Medicaid
300127615OtherRR MEDICARE
MN452493400Medicaid
MN51055CLOtherBCBS
MN1601373OtherMEDICA
MN140561OtherUCARE
MNHP33331OtherHEALTH PARTNERS
MNNA2951042430OtherPREFERRED ONE
MN1601373OtherMEDICA
MN452493400Medicaid