Sara Ashley Botterill, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Sartell, MN
NPI 1881809549 · NPPES record last updated May 20, 2020
Key facts
- NPI
- 1881809549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 65017 (MN)
- Practice address
- 1901 Connecticut Ave S
Sartell, MN 56377-2554 - Phone
- (320) 259-4100
- Fax
- (320) 257-5523
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- Virginia Commonwealth University, School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Glacial Ridge Hospital District
Polinsky Medical Rehabilitation Center
St Cloud Orthopedic Associates LTD
Medical Scanning Consultants PA
Practice addresses (Care Compare)
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521
1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360
1901 Connecticut Ave S
Sartell, MN 56377-2554
Phone (320) 259-4100
5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840
Hospital & facility affiliations
- Glacial Ridge Hospital
- Centracare - St. Cloud Hospital
- Prairie Ridge Hospital and Health Services
- St Gabriels Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.31 of 100
- Quality
- 74.55
- Promoting interoperability
- 79
- Improvement activities
- 40
- Cost
- 83.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190315000393 | MN | Practitioner - Physical Medicine and Rehabilitation | 5698847804 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65017 | MN | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cdi Twin Cities ASC LLC | Current | Accepting new patients | |
| St. Cloud Orthopedic Associates, LTD. | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Medical Scanning Consultants PA | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Medical Scanning Consultants PA | Current | Accepting new patients | |
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Medical Scanning Consultants PA | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Past | Accepting new patients | |
| County of Meeker | Past | Accepting new patients |
Locations
10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157
417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157
3315 Roosevelt Rd
Ste 200B
Saint Cloud, MN 56301
Phone (320) 259-4100
1901 Connecticut Ave S
Sartell, MN 56377
Phone (320) 259-4100
5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/glac-1755385c
- abotterill@stcloudortho1831.srs-direct.com
- abotterill433011@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 0101244146 | VA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 65017 | MN | Yes |
Addresses
Primary practice location
1901 Connecticut Ave S
Sartell, MN 56377-2554
Mailing address
1901 Connecticut Ave S
Sartell, MN 56377-2554
Phone (320) 259-4100
Other practice location 1
3315 Roosevelt Rd Ste 200B
Saint Cloud, MN 56301-9687
Phone (320) 259-4100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881809549 | Medicaid | MN | |
| 1881809549 | Medicaid | VA | |
| P00686666 | Other | VA | MEDICARE RAILROAD |
Other names
- Sara Ashley McCowen
Other providers in Sartell, MN
- Jody Allison Bolton Smith
- Naveah Marie Bonacci
- Sydney Elizabeth Bordson
- Chad Bosl
- Kaitlyn Mae Bottem
- Elizabeth Claire Boyd
- Riley Corey Boyer
- Mark Anthony Brenner
- Bryan James Brindley
- Taryn Elizabeth Broda
All providers in Sartell, MN · Physical Medicine & Rehabilitation Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.