Individual provider Active NPI

Jaren Steven Lukach, CNP

  • Family Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1164040804
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7538 Issued in MN
Practice address
251 County Road 120
Saint Cloud, MN 56303-4872
Phone
(320) 529-4741
NPI assigned
Jul 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7538 MN Primary

Addresses

Primary practice location

251 County Road 120
Saint Cloud, MN 56303-4872

Mailing address

247 9 1/2 St N
Sauk Rapids, MN 56379-2225
Phone (320) 237-5848

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020003416 MN Practitioner - Nurse Practitioner 9830519412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

2000 23Rd St S
Sartell, MN 56377-4765
Phone (320) 202-8949

Hospital & facility affiliations

  • Centracare Home Health Home health agency, Waite Park, MN, CCN 247117
  • Centracare Hospice Hospice, Waite Park, MN, CCN 241500
  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7538MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Aug 1, 2020 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2020 Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

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

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

251 County Road 120
Sartell, MN 56303
Phone (320) 202-8949

Interoperability endpoints

  • Direct secure messaging: jlukach525738@direct.centracare.com

Organizations & group practices 5

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 8

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": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1164040804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 9 1/2 ST N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792225",
            "telephone_number": "320-237-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-529-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKACH",
        "first_name": "JAREN",
        "middle_name": "STEVEN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.