NPIMap

Individual provider Active NPI

Carolyn Dee Rysgaard, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Cloud, MN
National Provider Identifier
1497048276
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD-42330 Issued in IA
Practice address
1406 6TH Avenue North
St Cloud Pathologists PA
St Cloud, MN 56303-1901
Phone
(320) 255-5632
Fax
(320) 255-5734
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R-9174 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD-42330 IA Primary

Addresses

Primary practice location

1406 6TH Avenue North
St Cloud Pathologists PA
St Cloud, MN 56303-1901

Mailing address

1406 6TH Avenue North
St Cloud Pathologists PA
St Cloud, MN 56303-1901
Phone (320) 255-5632

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
I20170523000316 MN Practitioner - Pathology 3375786387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud Pathologists PAGroup PAC ID 8921025511, 8 clinicians

Practice addresses (Care Compare)

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone 320251270057309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-9174IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Cloud Pathologists PA CurrentSince Jul 1, 2017 Accepting new patients
Centracare Health Systems Current Accepting new patients

Locations

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

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • Direct secure messaging: crysgaard368078@direct.centracare.com

Organizations & group practices 2

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1497048276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD PATHOLOGISTS PA",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-255-5632",
            "fax_number": "320-255-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD PATHOLOGISTS PA",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-255-5632",
            "fax_number": "320-255-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYSGAARD",
        "first_name": "CAROLYN",
        "middle_name": "DEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "R-9174",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "MD-42330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.