Avera Granite Falls
Organization Active NPI Family Medicine Physician · Granite Falls, MN
NPI 1700429644 · NPPES record last updated Jun 12, 2026
Key facts
- NPI
- 1700429644
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- AVERA GRANITE FALLS
- Practice address
- 345 10TH Ave
Granite Falls, MN 56241-1442 - Phone
- (320) 564-3111
- NPI assigned
- Oct 23, 2019
- Organization subpart
- No
Authorized official
- Name
- Debra Streier
- Title
- President/Ceo
- Phone
- (507) 537-9160
Other NPIs with the same Medicare PAC ID 3
Member of 1
Practitioners 87
-
Kristen Anne Altermatt, RN, CNP
-
Troy Charles Bruns, D.N.P
-
Kate Marie Hegna, PA-C
-
Timothy K Joyce, RN CNP
-
Jennifer Ann Monson, FNP-C
-
Arthur J Rillo, MD
-
Jane Marie Vansickle, PHD, LP
-
Noah N Chelliah, MD
-
Maneesh C. Kanal, MD
-
Steven L Kidd, MD
-
Kassandra Elizabeth Anderson, FNP-C
-
Ganesh Asaithambi, M.D.
-
Darrell L Carter, MD
-
Matthew R Casey, MD
-
Jesse J Corry, MD
-
Scena Dethlefs, LICSW
-
Amanda Kate Enestvedt, RN CPNP-PC
-
Daniel F Florey, MD
-
Wangcai Gao, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200106000646 | MN | Part B Supplier - Clinic/Group Practice | 1456784560 |
Receives reassigned benefits from 87 practitioners Practice locations: Granite Falls, MN |
National Provider Directory
Locations
345 10th Ave
Granite Falls, MN 56241
Phone (320) 564-3111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X | |||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
345 10TH Ave
Granite Falls, MN 56241-1442
Mailing address
PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7293
Other names
- AVERA MEDICAL GROUP GRANITE FALLS
- Avera Granite Falls Clinic
Other providers in Granite Falls, MN
- Stephanie Almanza
- Avera Granite Falls
- Avera Granite Falls
- Avera Granite Falls
- Avera Granite Falls
- Jessica Ann Bjorlie
- Taylor Noelle Bradshaw
- Darrell L Carter
- Autumn Alise Cavender-Wilson
- Erik Cherveny
All providers in Granite Falls, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.