NPIMap

Individual provider Active NPI

John M Mahowald, MD

  • Cardiovascular Disease Physician
  • Saint Cloud, MN
National Provider Identifier
1952303570
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25694 Issued in MN
Practice address
1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone
(320) 252-5131
Fax
(320) 240-2118
NPI assigned
Aug 12, 2005
Last updated
Oct 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25694 MN Primary

Addresses

Primary practice location

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

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
736805400MedicaidMN

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
I20090814000589 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042364788 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Minnesota Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians
Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

111 17TH E Ave
Centracare Dialysis Alexandria
Alexandria, MN 56308-3703
Phone (800) 835-6652

114 W 3Rd St
Monticello, MN 55362-8791

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

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

1406 6TH Ave N
St Cloud, MN 56303-1901

1406 6TH Ave No
St Cloud, MN 56303-1901

1815 Wisconsin Ave
Swift County Hospital
Benson, MN 56215-1653
Phone (320) 843-4232

4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

415 Jefferson St N
Wadena, MN 56482-1296

815 2ND St SE
Little Falls, MN 56345-3505

824 N 11TH St
Montevideo Hospital
Montevideo, MN 56265-1629
Phone (320) 295-2133

PO Box
Chicago, IL 60673

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC CurrentSince Mar 1, 2020 Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2009 Accepting new patients
Astera Health Current Accepting new patients
Mille Lacs Health System CurrentSince Jan 1, 2024 Accepting new patients
Centracare Health System-NR LLC CurrentSince Mar 1, 2020 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2009 Accepting new patients
Astera Health CurrentSince Jan 1, 2020 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Centracare Health System-NR LLC Cardiovascular Disease Current Accepting new patients
Mille Lacs Health System Current Accepting new patients
Mille Lacs Health System CurrentSince Jan 1, 2024 Accepting new patients
Astera Health CurrentSince Jan 1, 2020 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

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

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

4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

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

Interoperability endpoints

  • Direct secure messaging: jmahowald1421@direct.centracare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 12

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1952303570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHOWALD",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "25694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "736805400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.