NPIMap

Individual provider Active NPI

Wade Paulson

  • Surgery Physician
  • Saint Cloud, MN
National Provider Identifier
1447645916
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
66799 Issued in MN
Practice address
1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone
(320) 252-3342
NPI assigned
Apr 1, 2015
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 66799 MN Primary

Addresses

Primary practice location

1200 6TH Ave N
Saint Cloud, MN 56303-2735

Mailing address

1400 W 22ND St
Sioux Falls, SD 57105-1554
Phone (605) 357-1391

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
I20200526000075 MN Practitioner - General Surgery 1355656984 Reassigns benefits to 14 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Sanford School of Medicine of University of South Dakota, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians
Centracare Health System-NR LLCGroup PAC ID 3870739410, shared by 4 NPIs, 63 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 295-2945

1200 6TH Ave N
Centracare Clic River Campus
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

50 Centracare Dr
Long Prairie, MN 56347-2100
Phone (320) 732-2141

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)12
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
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 May 1, 2020 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Health System - Long Prairie CurrentSince May 1, 2020 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Jan 1, 2022 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince May 1, 2020 Accepting new patients
Cura of Sauk Centre LLC CurrentSince May 1, 2020 Accepting new patients
Unity Family Healthcare CurrentSince Jan 24, 2023 Accepting new patients
Centracare Health System-NR LLC CurrentSince May 1, 2020 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Centracare Clinic CurrentSince May 1, 2020 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince May 1, 2020 Accepting new patients
Centracare Health System-NR LLC CurrentSince May 1, 2020 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health-Paynesville LLC Current Accepting new patients
Centracare Health System - Melrose CurrentSince May 1, 2020 Accepting new patients
Centracare Health System - Melrose CurrentSince May 1, 2020 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Unity Family Healthcare Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Jan 1, 2022 Accepting new patients
Unity Family Healthcare CurrentSince Jan 24, 2023 Accepting new patients
St. Cloud Hospital Past Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
St Cloud Medical Group PA Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

1108 1st St SE
Little Falls, MN 56345
Phone (320) 632-3671

811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

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

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

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: wpaulson522042@direct.centracare.com

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1447645916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051554",
            "telephone_number": "605-357-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "66799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.