Individual provider Active NPI

Samantha Wetzel, CNP

  • Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1750166500
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10543 Issued in MN
Practice address
1301 33Rd St S Ste 202
Saint Cloud, MN 56301-9604
Phone
(701) 212-6488
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10543 MN Primary

Addresses

Primary practice location

1301 33Rd St S Ste 202
Saint Cloud, MN 56301-9604

Mailing address

1301 33Rd St S Ste 202
Saint Cloud, MN 56301-9604
Phone (701) 212-6488

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
I20231122003007 MN Practitioner - Nurse Practitioner 3375991748 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1301 33Rd St S
St Cloud, MN 56301-9668
Phone (320) 251-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2023 Accepting new patients
St. Cloud Hospital CurrentSince Nov 1, 2023 Accepting new patients
St. Cloud Hospital CurrentSince Nov 1, 2023 Accepting new patients
Centracare Clinic CurrentSince Nov 1, 2023 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Nov 1, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2023 Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1301 33rd St S
Ste 202
Saint Cloud, MN 56301
Phone (320) 251-9675

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1301 33rd St S
Saint Cloud, MN 56301
Phone (320) 240-6955

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: swetzel763158@direct.centracare.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1750166500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 33RD ST S STE 202",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019604",
            "telephone_number": "701-212-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 33RD ST S STE 202",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019604",
            "telephone_number": "701-212-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "SAMANTHA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "10543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.