NPIMap

Organization Active NPI

St. Mary's Medical Center

Doing business as Essentia Health St. Mary's Heart and Vascular Center

  • Clinic/Center
  • Duluth, MN
National Provider Identifier
1821835851
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ST. MARY'S MEDICAL CENTER
Doing business as
Essentia Health St. Mary's Heart and Vascular Center
Practice address
402 E 2ND St
Duluth, MN 55805-1906
Phone
(218) 786-3443
Fax
(218) 720-4633
NPI assigned
Jul 9, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ESSENTIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Bradley Beard
Title
Coo
Phone
(218) 786-5652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

402 E 2ND St
Duluth, MN 55805-1906

Mailing address

402 E 2ND St
Duluth, MN 55805-1906
Phone (218) 786-3443

Other names 1

  • Essentia Health St. Mary's Heart and Vascular Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000118 MN Part B Supplier - Clinic/Group Practice 6901706357 Receives reassigned benefits from 213 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Duluth, MN

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

1502 London Rd
Ste 100
Duluth, MN 55812
Phone (218) 722-6035

Practitioners & affiliated clinicians

Practitioners 217

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 217

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1821835851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051906",
            "telephone_number": "218-786-3443",
            "fax_number": "218-720-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051906",
            "telephone_number": "218-786-3443",
            "fax_number": "218-720-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESSENTIA HEALTH",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "218-786-5652"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health St. Mary's Heart and Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.