NPIMap

Organization Active NPI

Pine Medical Center

  • Ambulance
  • Sandstone, MN
National Provider Identifier
1154852937
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
0195 Issued in MN
Legal business name
PINE MEDICAL CENTER
Practice address
705 Lundorff Dr
Sandstone, MN 55072-5099
Phone
(320) 245-2211
NPI assigned
Mar 23, 2017
Organization subpart
Yes
Parent organization
ST MARY'S DULUTH CLINIC HEALTH SYSTEMAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Michael Hedrix
Title
Administrator
Phone
(320) 245-5605

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 1

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

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

Affiliated clinicians 86

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

View all 86

Medicare Care Compare: Hospital

Listed as
Essentia Health Sandstone CCN 241309
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Hospital certification: CCN 241309

Legal name
PINE MEDICAL CENTER
Doing business as
ESSENTIA HEALTH SANDSTONE
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2000
Last certification
Jul 9, 2025
Beds
35 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Sep 1, 1997 in MN
Enrollment address
705 Lundorff Dr
Sandstone, MN 55072-5099

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Krista Ann Skorupa
Individual 		Corporate Officer
President		 May 6, 2024
Anthony Sertich
Individual 		Corporate Director
Board Member		 Jan 1, 2021
Adam Bachand
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Thomas Jamar
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Sam Barney
Individual 		W-2 Managing Employee
Administrator		 Aug 28, 2023
Rebecca Urbanski
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Anthony Yung
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Essentia Health
Organization · Duluth, MN
Non-profit 		5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Justin Terch
Individual 		Corporate Director
Board Member		 Oct 22, 2025
St Marys Duluth Clinic Health System
Organization · Duluth, MN
Non-profit 		Operational/Managerial Control Sep 1, 1997 100%
Kevin S Boren
Individual 		Corporate Officer
VP of Finance		 Aug 30, 2021
W-2 Managing Employee
VP of Finance		 Aug 30, 2021
Troy Duininck
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Michael Watters
Individual 		Corporate Officer
Secretary		 Jul 1, 2023
Bruce Smith
Individual 		Corporate Director Jan 1, 2026
Nancy Aronson Norr
Individual 		Corporate Director
Board Member		 Jan 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20061104000642 MN Part a Provider - Critical Access Hospital 3870406945 Receives reassigned benefits from 132 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandstone, MN; Hinckley, MN

National Provider Directory

Part of
St Marys Duluth Clinic Health System

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 0195 MN Primary
Ambulance 341600000X 1967 MN

Addresses

NPPES NPI Registry

Primary practice location

705 Lundorff Dr
Sandstone, MN 55072-5099

Mailing address

705 Lundorff Drive
Sandstone, MN 55072-5120
Phone (320) 245-2211

Other practice location 1

109 Court Ave S
Sandstone, MN 55072-5120
Phone (320) 245-2211

Other names 1

NPPES NPI Registry
  • Essentia Health Emergency Medical Services-Sandstone Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154852937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 LUNDORFF DRIVE",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550725120",
            "telephone_number": "320-245-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LUNDORFF DR",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550725099",
            "telephone_number": "320-245-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Court Ave S",
            "address_purpose": "LOCATION",
            "city": "Sandstone",
            "state": "MN",
            "postal_code": "550725120",
            "country_code": "US",
            "telephone_number": "320-245-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARY'S DULUTH CLINIC HEALTH SYSTEM",
        "enumeration_date": "2017-03-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HEDRIX",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-245-5605"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MN",
            "license": "0195",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MN",
            "license": "1967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Emergency Medical Services-Sandstone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandstone, MN

Sources for this page

Verify at the official NPI Registry.