Individual provider Active NPI

Daniel J. Gerwing, PA-C

  • Physician Assistant
  • Saint Cloud, MN
National Provider Identifier
1609347012
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12869 Issued in MN
Practice address
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone
(320) 229-5099
NPI assigned
Dec 10, 2018
Last updated
Dec 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12869 MN Primary

Addresses

Primary practice location

1900 Centracare Cir
Saint Cloud, MN 56303-5000

Mailing address

1521 9TH Ave N
Sartell, MN 56377-1400
Phone (605) 651-3693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190115000692 MN Practitioner - Physician Assistant 9830109107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, 69 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12869MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince Mar 1, 2022 Accepting new patients
Glacial Ridge Hospital District CurrentSince Mar 1, 2022 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients

Locations

111 Pleasant Ave N
Brooten, MN 56316
Phone (320) 346-2272

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1609347012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 9TH AVE N",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771400",
            "telephone_number": "605-651-3693"
        },
        {
            "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": "320-229-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERWING",
        "first_name": "DANIEL",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.