NPIMap

Individual provider Active NPI

Kathryn A Mechelke, MD

  • Family Medicine Physician
  • Saint Cloud, MN
National Provider Identifier
1366432015
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44015 Issued in MN
Practice address
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone
(320) 229-4917
Fax
(320) 229-5181
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44015 MN Primary

Addresses

Primary practice location

1900 Centracare Cir
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone (320) 229-4917

Other identifiers 8

IdentifierTypeStateIssuer
083483100OtherMEDICAL ASSISTANCE
1328113OtherARAZ GROUP/AMERICA'S PPO
0107722OtherMEDICA HEALTH PLANS
140249OtherU-CARE
HP33397OtherHEALTH PARTNERS
1027779OtherPREFERRED ONE
2114101OtherFIRST HEALTH PLAN
49F16MEOtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100216000648 MN Practitioner - Family Practice 2769526698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
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)

1900 Centracare Cir
Suite 1450
Saint Cloud, MN 56303-5000
Phone (320) 229-4917

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Mar 1, 2020 Accepting new patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
St. Cloud Hospital CurrentSince May 1, 2020 Accepting new patients
St. Cloud Hospital CurrentSince May 1, 2020 Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

1900 Centracare Cir
#1450
Saint Cloud, MN 56303
Phone (320) 229-4917

1555 Northway Dr
Ste 200
Saint Cloud, MN 56303
Phone (320) 240-3157

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

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

1555 Northway Dr
#H
Saint Cloud, MN 56303
Phone (320) 240-3157

Interoperability endpoints

  • Direct secure messaging: kmechelke1447@direct.centracare.com

Organizations & group practices 7

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1366432015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4917",
            "fax_number": "320-229-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4917",
            "fax_number": "320-229-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECHELKE",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "44015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "083483100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP/AMERICA'S PPO",
            "identifier": "1328113",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "0107722",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "140249",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP33397",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1027779",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "2114101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49F16ME",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.