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Centracare Clinic

Organization Active NPI Multi-Specialty Clinic/Center · Sartell, MN

NPI 1780125849 · NPPES record last updated Nov 19, 2020

Key facts

NPI
1780125849
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
CENTRACARE CLINIC
Practice address
2000 23Rd St S
Sartell, MN 56377-4765
Phone
(320) 229-5120
Fax
(320) 200-3235
NPI assigned
Mar 9, 2017
Organization subpart
No

Authorized official

Name
Michael A Blair
Title
Sr VP & Cfo
Phone
(320) 255-5665

Other NPIs on the same Medicare enrollment 26

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

View all 26

Other NPIs with the same Medicare PAC ID 13

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

Corporate family (same tax ID) 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Practitioners 812

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 812

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MN

Medicare enrollment records

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
O20170706003049 MN DME Supplier - Physician - Unknown Physician Specialty 2466363395 Practice locations: Sartell, MN

National Provider Directory

Tax ID family
Clearwater Express Care (12 organizations share this tax ID)

Locations

1900 Centracare Cir
Ste 19
Saint Cloud, MN 56303

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

2000 23Rd St S
Sartell, MN 56377-4765

Mailing address

1200 6TH Ave N
Saint Cloud, MN 56303-2735

Other names

  • CentraCare Eye Center Doing business as

Other providers in Sartell, MN

All providers in Sartell, MN · Multi-Specialty Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.