NPIMap

Individual provider Active NPI

Kathleen A. Rieke, MD

  • Neurology Physician
  • St Cloud, MN
National Provider Identifier
1396899449
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
48271 Issued in MN
Practice address
1200 Sixth Ave No
Centracare Clinic
St Cloud, MN 56303-2735
Phone
(320) 252-5131
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 48271 MN Primary

Addresses

Primary practice location

1200 Sixth Ave No
Centracare Clinic
St Cloud, MN 56303-2735

Mailing address

1200 Sixth Ave No
Centracare Clinic
St Cloud, MN 56303-2735
Phone (320) 252-5131

Other names 1

  • Kathleen A. Fisher Former name

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
I20080701000251 MN Practitioner - Neurology 8729150180 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of North Dakota School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians
Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone (320) 654-3630

4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

415 Jefferson St N
Wadena, MN 56482-1296

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48271MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Astera Health Current Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2009 Accepting new patients
Astera Health CurrentSince Dec 1, 2022 Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2009 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

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Interoperability endpoints

  • Direct secure messaging: krieke12209@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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240444800000",
    "number": "1396899449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE NO",
            "address_2": "CENTRACARE CLINIC",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE NO",
            "address_2": "CENTRACARE CLINIC",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEKE",
        "first_name": "KATHLEEN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "48271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "FISHER",
            "middle_name": "A.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.