NPIMap

Organization Active NPI

St. Joseph's Medical Center

Doing business as Essentia Health-St. Joseph's Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
National Provider Identifier
1568415974
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
334411 Issued in MN
Legal business name
ST. JOSEPH'S MEDICAL CENTER
Doing business as
Essentia Health-St. Joseph's Medical Center
Practice address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone
(218) 829-2861
Fax
(218) 828-3103
NPI assigned
May 18, 2006
Last updated
Jun 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ESSENTIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Kevin Boren
Title
VP of Finance
Phone
(218) 786-1009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU
General Acute Care Hospital 282N00000X 334411 MN Primary

Addresses

Primary practice location

523 N 3Rd St
Brainerd, MN 56401-3054

Mailing address

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861

Other identifiers 2

IdentifierTypeStateIssuer
736045200MedicaidMN
1553HJOOtherMNBLUE CROSS

Other names 1

  • Essentia Health-St. Joseph's Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20030702000029 MN Part A Provider - Hospital 8224948443 10 other NPIs on this enrollment
Practice locations: Pierz, MN; Pillager, MN; Brainerd, MN; Pequot Lakes, MN; Crosslake, MN; Staples, MN; Pine River, MN; Deerwood, MN…
O20031119000468 MN Part B Supplier - Clinic/Group Practice 8224948443 Receives reassigned benefits from 361 practitioners
14 other NPIs on this enrollment
Practice locations: Pequot Lakes, MN; Pierz, MN; Pillager, MN; Pine River, MN; Plymouth, MN; Saint Paul, MN; Crosslake, MN; Shoreview, MN…
O20230117002220 MT Part B Supplier - Clinic/Group Practice 8224948443 Receives reassigned benefits from 1 practitioner
Practice locations: Bonner, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568415974. Details of each certification follow.

Hospital certification: CCN 240075

Legal name
ST JOSEPHS MEDICAL CENTER
Doing business as
ESSENTIA HEALTH - ST JOSEPHS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 1, 2015
Beds
162
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 1985 (2 total)
Organization structure
CorporationNon-profit
Enrollment address
523 N 3Rd St
Brainerd, MN 56401-3054
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 14

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

View all 14

Care Compare: Hospital

Medicare Care Compare
Listed as
Essentia Health St Joseph's Medical CenterCCN 240075 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Krista Ann Skorupa Individual Corporate OfficerPresident May 6, 2024
Mark Bortnem Individual Corporate OfficerTreasurer Sep 25, 2025
Amy Bergstrom Individual Corporate DirectorBoard Member Jan 1, 2024
Anthony Sertich Individual Corporate DirectorBoard Member Jan 1, 2021
George Loban Individual Corporate DirectorBoard Member Jan 1, 2024
Adam Bachand Individual Corporate DirectorBoard Member Jan 1, 2025
Thomas Jamar Individual Corporate DirectorBoard Member Jan 1, 2023
Rebecca Urbanski Individual Corporate DirectorBoard Member Jan 1, 2025
Anthony Yung Individual Corporate DirectorBoard Member Jan 1, 2023
Essentia Health Organization, Duluth, MN Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Beverly Raway Individual Corporate DirectorBoard Member Jan 1, 2017
St Marys Duluth Clinic Health System Organization, Duluth, MN Non-profit Operational/Managerial Control Jul 1, 2023
Bradley J Beard Individual Corporate OfficerChief Operating Officer Jul 1, 2023
W-2 Managing EmployeeChief Operating Officer Jul 1, 2023
Jeanne Weber Individual Corporate DirectorBoard Member Feb 15, 2019
Sandra Zutz-Wiczek Individual W-2 Managing EmployeeAd; May 6, 2024
Kevin S Boren Individual Corporate OfficerVP of Finance Jan 3, 2022
W-2 Managing EmployeeVP of Finance Jul 1, 2023
Troy Duininck Individual Corporate DirectorBoard Member Jan 1, 2023
Michael Watters Individual Corporate OfficerSecretary Jul 1, 2023
Jan Linse Baldwin Individual Corporate Director Jan 1, 2017
Nancy Aronson Norr Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 5

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

Facilities with the same owner 46

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

View all 46

Practitioners & affiliated clinicians

Practitioners 405

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 405

Affiliated clinicians 342

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

View all 342

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1568415974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-829-2861",
            "fax_number": "218-828-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-829-2861",
            "fax_number": "218-828-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESSENTIA HEALTH",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "BOREN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "218-786-1009"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "334411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "736045200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1553HJO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health-St. Joseph's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health-St. Joseph's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.