NPIMap

Organization Active NPI

St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
National Provider Identifier
1043240922
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
1041 Issued in WI
Legal business name
ST. CROIX REGIONAL MEDICAL CENTER
Practice address
235 State St
Saint Croix Falls, WI 54024-4117
Phone
(715) 483-3221
Fax
(715) 483-0507
NPI assigned
Jul 4, 2006
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Mike Youso
Title
Cfo
Phone
(715) 483-0535

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Urgent Care Clinic/Center 261QU0200X 1041 WI
Critical Access Hospital 282NC0060X 1041 WI Primary
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X
Physical Therapy Assistant 225200000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

235 State St
Saint Croix Falls, WI 54024-4117

Mailing address

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

Other identifiers 9

IdentifierTypeStateIssuer
CE8643OtherWIRR MEDICARE CLINIC
E8643OtherWIRR MEDICARE HOSPITAL
1006064OtherWIPREFERRED ONE
914OtherWIHEALTHPARTNERS
11015000MedicaidWI
5006381OtherWIMEDICA
63Q99RIOtherMNBCBS MN PROFESSIONAL CHGS
11015010MedicaidWI
196547600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040205000217 WI Part B Supplier - Clinic/Group Practice 9335032184 Receives reassigned benefits from 477 practitioners
Practice locations: Saint Croix Falls, WI; Webster, WI; Frederic, WI; Balsam Lake, WI
O20061104000660 WI Part A Provider - Critical Access Hospital 9335032184 Receives reassigned benefits from 188 practitioners
Practice locations: Balsam Lake, WI; Frederic, WI; Saint Croix Falls, WI; Webster, WI
O20110929000165 MN Part B Supplier - Clinic/Group Practice 9335032184 Receives reassigned benefits from 259 practitioners
Practice locations: Lindstrom, MN
O20111228000462 WI Part A Provider - Critical Access Hospital 9335032184 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Croix Falls, WI

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1043240922. Details of each certification follow.

Hospital certification: CCN 521337

Legal name
ST. CROIX REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 7, 2004
Last certification
Mar 11, 2026
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 15, 1954 in WI
Enrollment address
235E State St
Saint Croix Falls, WI 54024-4117

Hospital certification: CCN 52Z337

Legal name
ST. CROIX REGIONAL MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Mar 15, 1954 in WI
Enrollment address
235E State St
Saint Croix Falls, WI 54024-4117
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
St Croix Regional Medical CenterCCN 521337 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0668689St Croix Regional Medical Center235 State St, St Croix Falls, WI 54024AccreditationJan 2, 2027
52D2051461St Croix Regional Medical Center235 State Street, Saint Croix Falls, WI 54024Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory

Member organizations 6

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

Locations

1611 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2127

13185 Saint Croix Ave
Lindstrom, MN 55045
Phone (651) 257-4445

107 Oak St E
Frederic, WI 54837
Phone (715) 327-4888

1200 Hosford St
Ste 107
Hudson, WI 54016
Phone (651) 278-3095

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Michael J Youso Individual Corporate OfficerCeo Jun 28, 2022
Kimberly J Ericson Individual Corporate OfficerCfo Apr 17, 2023
Tanya K Mortel Individual W-2 Managing EmployeeCredentialing Supervisor Jan 6, 1992
Trudy Canine Individual Corporate DirectorGoverning Board Chair Jan 1, 2021

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Adoray Home Health and HospiceBaldwin, WI, CCN 527137 Home health agency 5% Or Greater Direct Ownership Interest (18.62%) Sep 1, 2014
Adoray Home Health and HospiceBaldwin, WI, CCN 521521 Hospice 5% Or Greater Direct Ownership Interest (18.62%) Sep 1, 2014

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 522

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 522

Affiliated clinicians 227

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

View all 227

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1043240922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "YOUSO",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-483-0535"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "WI",
            "license": "1041",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WI",
            "license": "1041",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE CLINIC",
            "identifier": "CE8643",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE HOSPITAL",
            "identifier": "E8643",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1006064",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "914",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11015000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5006381",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN PROFESSIONAL CHGS",
            "identifier": "63Q99RI",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11015010",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196547600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Croix Falls, WI

Sources for this page

Verify at the official NPI Registry.