NPIMap

Individual provider Active NPI

John M Houle, MD

  • Plastic and Reconstructive Surgery Physician
  • St Cloud, MN
National Provider Identifier
1073531885
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
48468 Issued in MN
Practice address
3701 12TH St N
Suite 100
St Cloud, MN 56303
Phone
(320) 253-7257
Fax
(320) 251-2938
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 48468 MN Primary

Addresses

Primary practice location

3701 12TH St N
Suite 100
St Cloud, MN 56303

Mailing address

3701 12TH St N
Suite 100
St Cloud, MN 56303
Phone (320) 253-7257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060901000076 MN Practitioner - Plastic and Reconstructive Surgery 8426052507 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Medical College of Wisconsin, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

3701 12TH St N
Suite 100
Saint Cloud, MN 56303-2253
Phone (320) 253-7257

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy11
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Jun 1, 2023 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Jun 1, 2023 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Jun 1, 2023 Accepting new patients
Centracare Clinic CurrentSince Jan 1, 2017 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Aug 1, 2024 Accepting new patients
Centracare Health System-NR LLC CurrentSince Jun 1, 2023 Accepting new patients
Centracare Clinic CurrentSince Jan 1, 2017 Accepting new patients
Centracare Health System - Melrose CurrentSince Jun 1, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Aug 1, 2024 Accepting new patients
Three Rivers Pathology PA PastSince Aug 1, 2006 Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

3701 12th St N
Ste 100
Saint Cloud, MN 56303
Phone (320) 253-7257

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: jhoule1787@direct.centracare.com

Organizations & group practices 13

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.

View all 13

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073531885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N",
            "address_2": "SUITE 100",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-253-7257",
            "fax_number": "320-251-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N",
            "address_2": "SUITE 100",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-253-7257",
            "fax_number": "320-251-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOULE",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "48468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.