Individual provider Active NPI

Eileen D Dauer, M.D.

  • Otolaryngology Physician
  • St Cloud, MN
National Provider Identifier
1134210875
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
43629 Issued in MN
Practice address
1528 Northway Drive
St Cloud, MN 56303-1255
Phone
(320) 252-1166
Fax
(320) 257-1126
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 43629 MN Primary

Addresses

Primary practice location

1528 Northway Drive
St Cloud, MN 56303-1255

Mailing address

1528 Northway Drive
St Cloud, MN 56303-1255
Phone (320) 252-0233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040122000823 MN Practitioner - Otolaryngology 0941102743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Vanderbilt University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud Ear Nose and Throat Clinic PAGroup PAC ID 5496774242, 14 clinicians

Practice addresses (Care Compare)

111 17TH E Ave
Alexandria, MN 56308-5273
Phone (320) 762-6030

1528 Northway Dr
Saint Cloud, MN 56303-1255
Phone (320) 252-0233

425 Elm N St
Sauk Centre, MN 56378-1010
Phone (320) 352-2221

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Alomere Health Hospital, Alexandria, MN, CCN 240030
  • Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43629MNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cloud Ear, Nose & Throat Clinic, P.a. Otolaryngology CurrentSince Jun 30, 2009 Accepting new patients
St. Cloud Hospital PastSince Jul 1, 2016 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

1528 Northway Dr
Saint Cloud, MN 56303
Phone (320) 252-0233

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

Interoperability endpoints

  • Direct secure messaging: edauer12163@direct.centracare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1134210875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 NORTHWAY DRIVE",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031255",
            "telephone_number": "320-252-0233",
            "fax_number": "320-257-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 NORTHWAY DRIVE",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031255",
            "telephone_number": "320-252-1166",
            "fax_number": "320-257-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUER",
        "first_name": "EILEEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "43629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.