Individual provider Active NPI

Thomas G Schrup, MD

  • Pediatrics Physician
  • Saint Cloud, MN
National Provider Identifier
1811988769
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
37682 Issued in MN
Practice address
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone
(320) 654-3630
Fax
(320) 654-3657
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 37682 MN Primary

Addresses

Primary practice location

1900 Centracare Cir
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone (320) 654-3630

Other identifiers 11

IdentifierTypeStateIssuer
945323700MedicaidMN
HP25516OtherHEALTH PARTNERS
COMPOtherMMSI
51A41SCOtherBLUE CROSS BLUE SHIELD
COMPOtherCHAMPUS
110414OtherU CARE
556166OtherARAZ GROUP AMERICAS PPO
COMPOtherONE HEALTH PLAN GREAT WES
1006252OtherPREFERRED ONE
1202205OtherMEDICA HEALTH PLANS
2134218OtherFIRST HEALTH PLAN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000177 MN Practitioner - Pediatric Medicine 8628970720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

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

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1900 Centracare Cir
Saint Cloud, MN 56303-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37682MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Dec 3, 2009 Accepting new patients
Centracare Clinic CurrentSince Dec 3, 2009 Accepting new patients
Carris Health LLC CurrentSince Oct 1, 2022 Accepting new patients
St. Cloud Hospital Current Accepting new patients
St. Cloud Hospital CurrentSince Jan 1, 2021 Accepting new patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital CurrentSince Jan 1, 2021 Accepting new patients
Carris Health LLC CurrentSince Oct 1, 2022 Accepting new patients
Wayzata Children'S Clinic P.a. Pediatrics Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

1900 Centracare Cir
#1300
Saint Cloud, MN 56303
Phone (320) 654-3610

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

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

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: tschrup16@direct.centracare.com

Organizations & group practices 10

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1811988769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3630",
            "fax_number": "320-654-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3630",
            "fax_number": "320-654-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRUP",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "37682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945323700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP25516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMSI",
            "identifier": "COMP",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51A41SC",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "COMP",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "110414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP AMERICAS PPO",
            "identifier": "556166",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN GREAT WES",
            "identifier": "COMP",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1006252",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "1202205",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "2134218",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.