NPIMap

Organization Active NPI

Centracare Clinic

Doing business as CentraCare - Sartell Clinic

  • Primary Care Clinic/Center
  • Sartell, MN
National Provider Identifier
1689196339
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CENTRACARE CLINIC
Doing business as
CentraCare - Sartell Clinic
CentraCare Sauk Crossing
Practice address
2000 23Rd St S
Sartell, MN 56377-4765
Phone
(320) 202-8949
Fax
(320) 257-1733
NPI assigned
Jul 14, 2017
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRACARE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Michael Blair
Title
Cfo
Phone
(320) 255-5665

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X MN Primary

Addresses

Primary practice location

2000 23Rd St S
Sartell, MN 56377-4765

Mailing address

PO Box 735818
Chicago, IL 60673-5818
Phone (320) 252-5131

Other names 2

  • CentraCare - Sartell Clinic Doing business as
  • CentraCare Sauk Crossing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

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
O20171017000666 MN DME Supplier - Multi-Specialty - Physician 2466363395 Practice locations: Sartell, MN

Other NPIs with the same Medicare PAC ID 13

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

View all 13

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
Centracare Clinic - Long Prairie

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1689196339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735818",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735818",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 23RD ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774765",
            "telephone_number": "320-202-8949",
            "fax_number": "320-257-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRACARE CLINIC",
        "enumeration_date": "2017-07-14",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare - Sartell Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CentraCare Sauk Crossing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.