Cokato Charitable Trust

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

329785 Issued in MN

Legal business name

COKATO CHARITABLE TRUST

Doing business as

Cokato Manor

Practice address

182 Sunset Ave NW
Cokato, MN 55321-9620

Phone

(320) 286-2158

Fax

(320) 286-2031

NPI assigned

Oct 5, 2005

Last updated

Oct 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tresha Melquist

Title

Administrator

Phone

(320) 286-3103

Specialties & licenses 1

Addresses

Other identifiers 11

Other names 1

• Cokato Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164419057. Details of each certification follow.

• CCN 245412 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245412

Legal name

COKATO CHARITABLE TRUST

Doing business as

COKATO MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1987

Last certification

Apr 25, 2025

Beds

56

Ownership / control type

Nonprofit Corporation

Organization structure

OtherNon-profit

Enrollment address

182 Sunset Nwave
Cokato, MN 55321-9620

Nursing home name

COKATO MANOR

Listed as

Cokato ManorCCN 245412 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5652.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Cokato Charitable Trust6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Cokato Charitable Trust

  dba Cokato Manor Companion Care

  • In Home Supportive Care Agency
  • Cokato, MN
  • NPI 1023308749
  NPD tax ID
• Cokato Charitable Trust

  dba Brookridge

  • Assisted Living Facility
  • Cokato, MN
  • NPI 1104040211
  NPD tax ID
• Cokato Charitable Trust

  dba Edgewood Gables

  • Assisted Living Facility
  • Cokato, MN
  • NPI 1467745273
  NPD tax ID
• Cokato Charitable Trust

  dba Brookridge

  • Assisted Living Facility
  • Cokato, MN
  • NPI 1790102499
  NPD tax ID
• Cokato Charitable Trust

  dba Heritage Place

  • Alzheimer Center (Dementia Center)
  • Cokato, MN
  • NPI 1942424155
  NPD tax ID

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Brian John Dixon, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1528096161

  Adp of the SNF, Contracted Managing Employee

  CMS ownership

Practitioners 1

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.

• Brian John Dixon, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1528096161
  NPD (past)

Affiliated clinicians 2

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

• Brian John Dixon, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1528096161

  Nursing home

  Care Compare affiliation
• Thomas Joseph Styrvoky, MD

  • Family Medicine Physician
  • Cokato, MN
  • NPI 1689637241

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1164419057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SUNSET AVE NW",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553219620",
            "telephone_number": "320-286-2158",
            "fax_number": "320-286-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SUNSET AVE NW",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553219620",
            "telephone_number": "320-286-2158",
            "fax_number": "320-286-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COKATO CHARITABLE TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "MELQUIST",
        "authorized_official_first_name": "TRESHA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-286-3103"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "329785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CM MEDICA",
            "identifier": "7111807",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "961043000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CM PRIME WEST",
            "identifier": "040705008",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHH HEALTH PARTNERS",
            "identifier": "30437",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423526600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CM BCBS",
            "identifier": "9681CO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHH UCARE",
            "identifier": "167905",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHH MEDICA",
            "identifier": "5900013",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHH PRIME WEST",
            "identifier": "030802014",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249075700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMHH BCBS",
            "identifier": "5Z74CO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cokato Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cokato Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Jo Briggs, RPT
• Bruce Bohnsack DDS
• City of Cokato (Cokato Ambulance Service)
• Cokato Charitable Trust (Cokato Manor Companion Care)
• Cokato Charitable Trust (Brookridge)
• Cokato Charitable Trust (Cokato Manor Home Health)
• Cokato Charitable Trust (Edgewood Gables)
• Cokato Charitable Trust (Brookridge)
• Cokato Charitable Trust (Heritage Place)
• Cokato Chiropractic, P.a.

• Skilled Nursing Facility in Cokato, MN
• Providers in Cokato, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.