Victoria L Fenstermacher, CFNP
Individual provider Active NPI Family Nurse Practitioner · Becker, MN
NPI 1114074150 · NPPES record last updated Jan 2, 2008
Key facts
- NPI
- 1114074150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R1395617 (MN)
- Practice address
- 12800 Rolling Ridge
Centracare Clinic Becker
Becker, MN 55308 - Phone
- (763) 261-7000
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centracare Clinic
Practice addresses (Care Compare)
1200 6TH Ave N
Saint Cloud, MN 56303-2735
1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131
12800 Rolling Ridge Rd
Becker, MN 55308-8838
Phone (763) 261-7000
PO Box
Chicago, IL 60673
Hospital & facility affiliations
- Centracare Home Health
- Centracare Health - Monticello
- Centracare - St. Cloud Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040607000553 | MN | Practitioner - Nurse Practitioner | 7416939087 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0382048 | MN | MD | Family Nurse Practitioner |
| R1395617 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients |
Locations
12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
Interoperability endpoints
- vfenstermacher1028@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0382048 | MN | |
| Family Nurse Practitioner | 363LF0000X | R1395617 | MN | Yes |
Addresses
Primary practice location
12800 Rolling Ridge
Centracare Clinic Becker
Becker, MN 55308
Mailing address
12800 Rolling Ridge
Centracare Clinic Becker
Becker, MN 55308
Phone (763) 261-7000
Other providers in Becker, MN
- Dr. Stephanie Gruenes Center for Cosmetic Dentistry PA
- Eagan Eye Clinic LLC
- Essential Grace Therapy, PLLC
- Faith in Action in Greater Sherburne Coujnty
- Paul Jerome Fedor
- Caleb Foster
- Tamara Marie Gay
- Kurt William Gramith
- Stephanie L Gruenes
- Amber Ellen Hansen
All providers in Becker, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.