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Centracare Health - Benson LLC

Organization Active NPI Critical Access Hospital · Benson, MN

NPI 1326757154 · NPPES record last updated Jan 13, 2023

Key facts

NPI
1326757154
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
CENTRACARE HEALTH - BENSON LLC
Practice address
1815 Wisconsin Ave
Benson, MN 56215-1653
Phone
(320) 843-4232
NPI assigned
Nov 21, 2022
Organization subpart
No

Authorized official

Name
Michael Blair
Title
Cfo
Phone
(320) 255-5665

Owners & managing parties with NPI records 7

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

Facilities with the same owner 28

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 28

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 95

Affiliated clinicians 47

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

View all 47

Medicare Care Compare: Hospital

Listed as
Centracare - Benson CCN 241365
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MN

Hospital certification: CCN 241365

Legal name
CENTRACARE HEALTH - BENSON LLC
Doing business as
CENTRACARE - BENSON
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2005
Last certification
Jun 22, 2018
Beds
31 (25 certified)
Ownership / control type
Hospital district or authority
Most recent change of ownership
Jan 1, 2023 (2 total)
Organization structure
LLC · Non-profit
Incorporated
Jan 1, 2023 in MN
Enrollment address
1815 Wisconsin Ave
Benson, MN 56215-1653
Other Hospital Practice Location

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Tina SSN May
Individual 		Corporate Director Jul 1, 2025
Michelle Johnson
Individual 		Corporate Director Jul 1, 2021
Thomas Knoblach
Individual 		Corporate Director Jul 1, 2011
Michael a Blair
Individual 		Corporate Officer
Cfo/Sr VP		 Jan 1, 2023
W-2 Managing Employee
Cfo/Sr VP		 Jan 1, 2023
Jeffrey Gau
Individual 		Corporate Director Jul 1, 2017
Renee S Frauendienst
Individual 		Corporate Director
Board Member		 Jul 1, 2017
Jacob Lyons
Individual 		Corporate Director Jul 1, 2024
Richard Wehseler
Individual 		Corporate Director Apr 21, 2018
Bobbie Bertram
Individual 		Corporate Director Jul 1, 2015
Kenneth D Holmen
Individual 		Corporate Officer
Ceo/Board Member		 Jun 30, 2015
Sherri Liebl
Individual 		W-2 Managing Employee
Director of Revenue		 Sep 30, 2019
David Anfinson
Individual 		Corporate Director Apr 21, 2018
Daniel Abdul
Individual 		Corporate Director Jul 1, 2022
James Hebl
Individual 		Corporate Director Jul 1, 2017
Carrie Henning-Smith
Individual 		Corporate Director Jul 1, 2023
Centracare Health System
Organization · Saint Cloud, MN
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2023 100%
Bryan Rolph
Individual 		Corporate Director Jul 1, 2019

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230203001165 MN Part a Provider - Critical Access Hospital 1850761685 Receives reassigned benefits from 86 practitioners
Practice locations: Benson, MN
O20230411000460 MN Part B Supplier - Clinic/Group Practice 1850761685 Receives reassigned benefits from 86 practitioners
2 other NPIs on this enrollment
Practice locations: Benson, MN

National Provider Directory

Tax ID family
Centracare Health - Benson LLC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes

Addresses

Primary practice location

1815 Wisconsin Ave
Benson, MN 56215-1653

Mailing address

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other providers in Benson, MN

All providers in Benson, MN · Critical Access Hospital in Minnesota

Sources for this page

Verify at the official NPI Registry.