Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ALEX JACOB MANGAN MD
NPI 1669163614
Family Medicine in Waconia, MN

Q: What is Alex Mangan's NPI number?

The NPI number for Alex Mangan is 1669163614. It was assigned to this individual provider in the NPPES registry on May 18, 2023.

Q: What is Alex Mangan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Alex Mangan was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 18, 2023PECOS Enrolled

424 W STATE HIGHWAY 5, WACONIA, MN 55387(952) 442-4461(952) 442-1547 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 29, 2026, May 2, 2026, Aug 22, 2023 and 1 more (4 updates tracked since 2023).

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About Dr. Alex Jacob Mangan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALEX JACOB MANGAN MD (NPI 1669163614) is an individual family medicine provider in Waconia, Minnesota, licensed in Minnesota (81984) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1669163614

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. ALEX JACOB MANGANCredential: MD

Location Address424 W STATE HIGHWAY 5Waconia, MN 55387-1795

Mailing Address424 W State Highway 5Waconia, MN 55387-1795 · (952) 442-4461 · Fax (952) 442-1547

Phone(952) 442-4461

Fax(952) 442-1547

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMay 18, 2023

Last NPPES UpdateJuly 29, 20264 updates tracked since enumeration

NPPES CertifiedJuly 29, 2026

✔ NPI 1669163614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 81984

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

424 W STATE HIGHWAY 5, Waconia, MN 55387

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Alex Jacob Mangan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941780365

PECOS Enrollment IDI20260713000045

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Proctor Hospital

Acute Care Hospitals · Peoria, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140013

Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County

Emergency services

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140209

Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55387 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TESSA PAINTER SOMERMEYER DNP

Nurse Practitioner