NPIMap

Organization Active NPI

First Care Medical Services

Doing business as Essentia Health Fosston Clinic

  • Critical Access Hospital Clinic/Center
  • Fosston, MN
National Provider Identifier
1073638565
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
Legal business name
FIRST CARE MEDICAL SERVICES
Doing business as
Essentia Health Fosston Clinic
Practice address
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone
(218) 435-1133
Fax
(218) 435-1134
NPI assigned
Mar 21, 2007
Last updated
Oct 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Kim Bodensteiner
Title
Cfo
Phone
(218) 435-7633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X NU Primary

Addresses

Primary practice location

900 Hilligoss Blvd SE
Fosston, MN 56542-1542

Mailing address

900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone (218) 435-1133

Other identifiers 6

IdentifierTypeStateIssuer
0000452OtherMNMEDICA FOR MNCARE #
381347900MedicaidMN
89020OtherMNHEALTHPARTNERS GROUP #
3901610OtherMNMEDICA GROUP #
253K0FIOtherMNBLUE PLUS GROUP #
7T834FIOtherMNBLUE CROSS GROUP #

Other names 1

  • Essentia Health Fosston Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040927000035 MN Part B Supplier - Clinic/Group Practice 3678542842 Receives reassigned benefits from 106 practitioners
3 other NPIs on this enrollment
Practice locations: Bagley, MN; Fosston, MN; Oklee, MN

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1073638565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HILLIGOSS BLVD SE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421542",
            "telephone_number": "218-435-1133",
            "fax_number": "218-435-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HILLIGOSS BLVD SE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421542",
            "telephone_number": "218-435-1133",
            "fax_number": "218-435-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "BODENSTEINER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-435-7633"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA FOR MNCARE #",
            "identifier": "0000452",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381347900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS GROUP #",
            "identifier": "89020",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA GROUP #",
            "identifier": "3901610",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS GROUP #",
            "identifier": "253K0FI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP #",
            "identifier": "7T834FI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Fosston Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health Fosston Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fosston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.