NPIMap

Organization Active NPI

Centracare Clinic Melrose

  • Multi-Specialty Clinic/Center
  • Melrose, MN
National Provider Identifier
1629070230
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CENTRACARE CLINIC MELROSE
Practice address
525 W Main St
Melrose, MN 56352
Phone
(320) 256-4228
Fax
(320) 256-7106
NPI assigned
Aug 12, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRACARE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Thomas M Feldhege
Title
Treasurer Director of Finance
Phone
(320) 240-2152

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X MN Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

525 W Main St
Melrose, MN 56352

Mailing address

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

Other identifiers 5

IdentifierTypeStateIssuer
109966OtherUCARE
98-01249OtherMEDICA
35580OtherHEALTH PARTNERS
47A46CEOtherBCBS
NA135OtherPREF ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000293 MN Part B Supplier - Clinic/Group Practice 2466363395 Receives reassigned benefits from 1,127 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Part of
St Cloud Hospital

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1629070230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W MAIN ST",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "56352",
            "telephone_number": "320-256-4228",
            "fax_number": "320-256-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W MAIN ST",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "56352",
            "telephone_number": "320-256-4228",
            "fax_number": "320-256-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE CLINIC MELROSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRACARE CLINIC",
        "enumeration_date": "2005-08-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FELDHEGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "TREASURER DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "320-240-2152"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "109966",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "98-01249",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "35580",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "47A46CE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREF ONE",
            "identifier": "NA135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.