NPIMap

Individual provider Active NPI

Bethany Staehnke

  • Foot & Ankle Surgery Podiatrist
  • Crookston, MN
National Provider Identifier
1821470907
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
993 Issued in MN
Practice address
323 S Minnesota St
Crookston, MN 56716-1601
Phone
(218) 281-9200
NPI assigned
Jun 24, 2015
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 993 MN Primary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006649 PA

Addresses

Primary practice location

323 S Minnesota St
Crookston, MN 56716-1601

Mailing address

323 S Minnesota St
Crookston, MN 56716-1601

Other practice location 1

1400 Locust St
Building B, Room 9520
Pittsburgh, PA 15219-5114
Phone (218) 289-3682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180614000012 MN Practitioner - Podiatry 1850646993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview Healthcare AssociationGroup PAC ID 7810806718, shared by 6 NPIs, 46 clinicians

Practice addresses (Care Compare)

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.91 of 100Reported as group
Quality
88.07
Promoting interoperability
100
Improvement activities
40
Cost
74.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006649PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Healthcare Association Current Accepting new patients
Riverview Healthcare Association CurrentSince Dec 30, 2018 Accepting new patients
Riverview Healthcare Association CurrentSince Dec 30, 2018 Accepting new patients
Riverview Healthcare Association Current Accepting new patients
Riverview Healthcare Association CurrentSince Jan 10, 2026 Accepting new patients

Locations

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

1428 Central Ave NE
East Grand Forks, MN 56721
Phone (218) 773-1390

Organizations & group practices 5

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1821470907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Locust St",
            "address_2": "Building B, Room 9520",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152195114",
            "country_code": "US",
            "telephone_number": "218-289-3682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAEHNKE",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "993",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006649",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

Verify at the official NPI Registry.